俞红五主任针灸治疗老年性抑郁临床经验  

Director YU Hongwu’s experience in treating senile depression by acupuncture

作　　者：纪丽丽 俞红五[1] 宋宇轩 JI Lili

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230000

出　　处：《中医临床研究》2024年第5期141-145,共5页Clinical Journal Of Chinese Medicine

基　　金：安徽省临床医学研究中心(安徽省科技厅皖社科[2020]41号);安徽中医药大学大学生创新创业基金项目(S2022028)。

摘　　要：老年性抑郁是老年患者的常见病,虽然其西医对其发病机制至今尚未阐明,但中医可大致将其归为“郁证”“百合病”“脏躁”“失眠”等范畴。老年性抑郁有发病率高、病程缠绵、易反复等特点。俞红五主任通过多年临床工作经验总结认为该病可大致分为因病致郁和因郁致病,同时提出该病的病机为“气机失调,阴阳失和,肝气郁结,心神失养”。因此在治疗过程中始终贯穿“调气机、解心结、畅情志”的治疗原则,辨证使用“坛城针法”配合“下三皇穴”,同时辅以导引来治疗老年性抑郁。其中“坛城针法”的穴位组成为小天心穴(双)、太冲穴(双)、丰隆穴(双)及上下1寸各取一穴。该针方通过小天心穴、太冲穴及丰隆穴的“倒马针法”配合使用主要起到调畅气机、调和气血、平衡阴阳的治疗作用,从而达到“气机一调,心结自解”的治疗目的。“肾精渐衰”“肾气亏虚”是人生、长、壮、老、已中不可逾越的生理和病理过程,老年性抑郁患者大体总合并其他慢性疾病,病程缠绵,病情反复,遂总“以虚为本”。因此“补肾健脾”为老年患者的常用治法,对此辨证配合“下三皇穴”来共奏补益脾肾、培补先后天之本之功。二者配合使用在切中该病病机的同时也通过“补益脾肾”来调整老年人“以虚为本”的体质。在治疗过程中鼓励患者配合导引可以起到“移情易性”的辅助治疗作用。文章总结了俞红五主任运用针灸治疗老年性抑郁临床经验,结合病案对本病的病机、治则、治疗方法进行了较全面分析。Senile depression is a common disease in elderly patients,although its pathogenesis has not yet been elucidated by Western medicine,it can be roughly classified into the categories of depression syndrome,lily disease,irritability and insomnia.Senile depression has the characteristics of high incidence,lingering course and easy recurrence.Through the summary of years of clinical experience,Director YU Hongwu believes that the disease can be roughly divided into depression caused by illness and illnessS caused by depression,and at the same time proposes that the pathogenesis of the disease is imbalance of Qi(气)and organs,disharmony of Yin(阴)and Yang(阳),stagnation of liver Qi,and loss of nourishment of the mind.Therefore,in the treatment,the treatment principle of regulating the Qi,untying the knots in patients'mind,and unwinding the emotions has always been carried out,and the Tancheng acupuncture method(坛城针法)plus the Xia Sanhuang acupoints(下三皇穴)is used based on syndrome differentiation,and at the same time,it is supplemented by Chinese physical and breathing exercises to treat senile depression.Among them,the acupuncture points of the Tancheng acupuncture method are composed of Xiaotianxin(小天心穴)(double),Taichong(LR3)(double),Fenglong(ST40)(double)and one acupoint each in the upper and lower 1 inch.The acupuncture prescription is mainly used in the treatment for regulating Qi,harmonizing Qi and blood,and balancing Yin and Yang through the combination of Xiaotianxin,Taichong and Fenglong,the Daoma acupuncture method(倒马针法),which mainly plays the therapeutic role of regulating Qi,harmonizing Qi and blood,and balancing Yin and Yang,so as to achieve the therapeutic purpose of regulating Qi and self-dissolving knots.Tonifying the kidney and strengthening the spleen is a common treatment method for elderly patients,and based on syndrome differentiation,the Xia Sanhuang acupoints play a role of nourishing the spleen and kidney,and cultivating and replenishing the congenital and acquire

关 键 词：老年性抑郁 坛城针法 下三皇穴 导引 

分 类 号：R25[医药卫生—中医内科学]