基于血脉理论辨治经皮冠状动脉介入治疗术后焦虑抑郁  

Treatment of Post-PCI Anxiety and Depression Based on Blood Vessel Theory

作　　者：杨蕾 杨洁[2] YANG Lei;YANG Jie(Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《辽宁中医药大学学报》2024年第6期79-83,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(81804061);泰山学者岗位建设工程项目(tsqn202211352);山东省中医药科技项目(M-2023058)。

摘　　要：经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后焦虑抑郁是PCI术后的常见并发症之一,其严重影响了患者的生活质量和疾病的转归,西医治疗主要以传统抗精神类药物治疗为主,但患者接受度差。中医认为焦虑抑郁状态与“瘀”“郁”“虚”关系密切,解郁通脉、益气养血是治疗焦虑抑郁状态的关键,“血脉理论”以“气-血-脉”为理论体系,在心-血-脉系统中,心气充沛、血液充盈和脉道通利是心主血脉的基础,维系着人体正常的生理功能。该文以“血脉理论”为指导,辨证论治PCI术后焦虑抑郁,“血脉痹阻,气机郁滞”和“血脉亏虚,心神失养”为该病的主要病因病机,从“行气解郁、通利血脉”和“益气养血安神”两大治法出发,方选临床常用方金铃子散、解郁合欢汤,在“社会-心理-生物综合”医学模式的基础上,发挥中医治疗优势,为中医药治疗PCI术后焦虑抑郁提供新的思路。Anxiety and depression is one of the common complications after percutaneous coronary intervention(PCI),which seriously affects the patients'quality of life and disease outcome.Western medicine is mainly treated with traditional antipsychotics,but the patients'acceptance is poor.Traditional Chinese medicine believes that anxiety and depression are closely related to“stasis”“depression”and“deficiency”,and the key to the treatment of anxiety and depression is to relieve depression and promote pulse,supplementing Qi and blood is the key to the treatment of anxiety and depression.The“blood vessel theory”takes“Qi-blood-vessel”as its theoretical system.In the system of heart-blood-vessel,the heart's abundant Qi,abundant blood and fluent veins are the basis of the heart's main blood vessels,which maintain the normal physiological functions of the human body.Guiding by the“blood vessel theory”,this paper discusses the treatment of anxiety and depression after PCI based on syndrome differentiation.“Blood impediment,Qi stagnation”and“blood-vein deficiency,loss of nourishment of the heart and spirit”are the main causes and pathogenesis of the disease.Starting from the two major treatment methods of“carrying Qi to relieve depression,promoting blood circulation”and“supplemening Qi to nourish blood and calming nerves”,the commonly used clinical prescriptions of Jinlingzi Powder(金铃子散)and Jieyu Hehuan Decoction(解郁合欢汤)are selected.On the basis of the“society-psychological-biological integrated medical model”,the advantages of traditional Chinese medicine treatment are brought into play to provide new ideas for the treatment of anxiety and depression after PCI.

关 键 词：PCI术后焦虑抑郁 血脉理论 辨证论治 病因病机 治则方药 

分 类 号：R22[医药卫生—中医基础理论]