从“十一脏取决于胆”论治冠心病合并焦虑抑郁  

From the“Eleven Organs Depend on Gallbladder”on the treatment of coronary heart disease with anxiety depression

作　　者：丁帆 王玉玲[1,2] 崔向宁[1,2] DING Fan;WANG Yuling;CUI Xiangning(Bejing University of Chinese Medicine,Beijing 100029,China;Cardiovascular Department,Guang'anmen Hospital,Chinese Academy of Chinese Medical Sciences,Beijing 100053,China)

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

出　　处：《四川中医》2024年第5期34-37,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金委员会面上项目(编号:81973842)。

摘　　要：“十一脏取决于胆”首见于《素问》,强调胆在人体生命活动及临床治疗中的重要作用。冠心病具有病程长,易反复,需长期服药等特点,加之社会心理因素的影响,常易伴发焦虑抑郁。笔者在临床跟师过程中,发现导师从胆论治冠心病合并焦虑抑郁疗效显著,“十一脏取决于胆”的理论在临床中得到验证。导师认为,一者,肝胆相合,共主疏泄,与气机疏泄密切相关;二者,胆寄情志,疏调气机,精神活动,决断于胆;三者,胆蕴相火,通行气血,君相安位,则气血和调;因此,本病的病机主要在于气机失调,相火妄动,导致脏腑经络失和,神机失用。基于此病机,本文结合案例介绍从胆论治冠心病合并焦虑抑郁之经验,以期为临床提供治疗思路。“Eleven Organs Depend on Gallbladder”first appeared in Suwen,emphasizing the important role of gallbladder in human life activities and clinical treatment.Coronary heart disease has the characteristics of long course,easy to repeat,long-term medication,etc.,coupled with the influence of social psychological factors,it is often accompanied by anxiety and depression.In the process of clinical follow-up,the author found that the supervisor treated coronary heart disease complicated with anxiety and depression from the gallbladder theory has a significant effect,and the theory of“eleventh visceral depends on the gallbladder”has been verified in clinical practice.The teacher believes that one,the liver and gallbladder are combined,and the main drainage is closely related to the drainage of qi machines;The two,gallbladder sentiment,tempering qi machine,mental activity,decision in gall;The three,the gallbladder contains fire,the passage of qi and blood,and the position of the king,the qi and blood are harmonious;Therefore,the pathogenesis of this disease mainly lies in the imbalance of qi and fire,resulting in the loss of harmony of the internal organs and meridians,and the loss of the divine machine.Based on this pathogenesis,this article introduces the experience of treating coronary heart disease complicated with anxiety and depression from the bile theory based on cases,in order to provide treatment ideas for clinical practice.

关 键 词：冠心病合并焦虑抑郁 从胆论治 治法方药 

分 类 号：R541.4[医药卫生—心血管疾病]