马云枝诊治抑郁症经验  

Ma Yunzhi′s Experience in Diagnosis and Treatment of Depression

作　　者：史继鑫[1] 张君君[2] SHI Jixin;ZHANG Junjun(The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Provincial Hospital of Chinese Medicine,Zhengzhou Henan China 450002;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第二附属医院/河南省中医院,河南郑州450002 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2024年第2期354-358,共5页Acta Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目{豫中医业函〔2014〕86号}。

摘　　要：抑郁症的病因主要为情志内伤及体质素弱。肝失疏泄、脾失运化、心神失养及脏腑气血阴阳失调是其关键病机。其病位主要在肝,但可涉及心、脾、肾。临床根据脏腑辨证和虚实辨证,采用相应治则:从肝论治包括疏肝解郁、理气畅中法,疏肝泻热、安神定志法,理气解郁、活血化瘀法,疏肝解郁、健脾养血法;从心论治包括补血养心、除烦安神法,滋阴安神、补心养血法;从脾论治包括健脾养心、益气生血法,行气开郁、化痰散结法;从虚论治包括滋养阴精、补益肝肾法,健脾益肾、温阳补气法。同时善用对药柴胡配白芍,解郁疏肝;半夏配厚朴,行气散结;香附配川芎,理气活血;酸枣仁配合欢皮,解郁安神;郁金配青皮,调气解郁。结合情志调护,可获得奇效。The main causes of depression are emotional trauma and weak physical constitution.The key pathogenesis of Liver dysfunction,Spleen dysfunction,lack of nourishment of the mind,and imbalance of Qi,blood,Yin,and Yang in the organs are the key factors.Its main location is in the Liver,but it can involve the Heart,Spleen,and Kidney.According to the differentiation of Zang and Fu as well as deficiency or excess in clinical practice,corresponding treatment principles are adopted:treating from the perspective of Liver includes the methods of soothing the Liver and relieving depression,regulating Qi and promoting circulation,relieving Liver and Heat,calming the mind,regulating Qi and relieving depression,promoting blood circulation and removing stasis,regulating the Liver and relieving depression,strengthening the Spleen and nourishing blood.The treatment based on the Heart includes nourishing blood and the Heart,eliminating upset and calming the mind,nourishing Yin and calming the mind as well as nourishing the Heart and blood.The treatment based on the Spleen includes the methods of strengthening the Spleen and nourishing the Heart,nourishing Qi and generating blood,promoting Qi circulation and removing stagnation as well as resolving Phlegm and dispersing nodules.The treatment of deficiency includes nourishing Yin Essence,tonifying Liver and Kidney,strengthening Spleen and Kidney,warming Yang and supplementing Qi.At the same time,making good use of the herbal medicine Chaihu(radix bupleuri)combined with Baishao(radix paeoniae alba)to relieve depression and soothe the Liver;Banxia(minellia ternata)paired with Houpo(magnolia officinalis)can promote Qi circulation and disperse knots;Xiangfu(cyperus rotundus)combined with Chuanxiong(ligusticum wallichii)can regulate Qi and promote blood circulation;Suanzaoren(sour jujube kernels)combined with Hehuanpi(albizia bark)can relieve depression and calm the mind;Yujin(radix curcumae)paired with Qingpi(pericarpium citri reticulatae viride)can regulate Qi and relieve depression.All

关 键 词：抑郁症 从肝论治 从心论治 从脾论治 从虚论治 药对 马云枝 

分 类 号：R249.27[医药卫生—中医临床基础]