从胆论治室性早搏伴焦虑抑郁  

Treatment of Premature Ventricular Contractions with Anxiety and Depression from Gallbladder

作　　者：陈琛 王玉玲[1,2] 沈子焕[1,2] 焦林珂 丁帆 崔向宁 CHEN Chen;WANG Yuling;SHEN Zihuan;JIAO Linke;DING Fan;CUI Xiangning(Guang′anmen Hospital Affiliated to China Academy of Chinese Medical Sciences,Beijing China 100053;Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029

出　　处：《中医学报》2024年第3期475-479,共5页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(81973842)。

摘　　要：“心与胆相通”首见于《五脏穿凿论》,后经李梴引述:“心与胆通,心病怔忡,宜温胆为主;胆病战栗癫狂,宜补心为主。”心胆沟通于经络,协调于气机,统一于神志。该理论极大地概括了心胆疾病的治疗纲领,对于双心疾病的辨治具有重要指导意义。室性早搏伴焦虑抑郁以心胆失和为发病基础,神明动乱为病机关键。临证时应重在恢复胆疏泄升发之性、固护决断之权,即通过调治胆腑,使胆通则枢机转利、胆清则火郁得散、胆壮则神有所主,如此胆气畅达无碍,心脉通畅搏动有序,神明无所偏倚,有助于双心疾病的治疗。"Heart and Gallbladder being connected"was first proposed in Wu Zang Chuan Zao Lun.Later,it was quoted by Li Chan as follows:"The connection between the Heart and the Gallbladder and the treatment of palpitations of the Heart is to warm the Gallbladder;for the trembling and madness caused by gallbladder disease,it is advisable to nourish the Heart."The Heart and Gallbladder communicate with the meridians,coordinate with the Qi activity,and unify at the mind.This theory greatly summarizes the treatment guidelines for Heart and Gallbladder diseases and has important guiding significance for the differentiation and treatment of psycho-cardiological diseases.Ventricular premature beats accompanied by anxiety and depression are based on Heart and Gallbladder disharmony,with mind turmoil as the key pathogenesis.In clinical practice,emphasis should be placed on restoring the ability of Gallbladder in Qi dispersing and generating as well as the powder of decisiveness,that is,by regulating the Gallbladder to help it function smoothly.When the Gallbladder is clear and the stagnated Fire is dispersed,the Gallbladder would be stronger,and the mind can be controlled.In this way,the Gallbladder Qi can flow unobstructed,the Heart pulse can be smooth and orderly,and the mind can be free from bias,which is helpful for the treatment of psycho-cardiological diseases.

关 键 词：室性早搏 焦虑 抑郁 从胆论治 “心与胆相通” 心胆失和 

分 类 号：R256.21[医药卫生—中医内科学]