从气血论治围绝经期抑郁症  

Treating Perimenopausal Depression from the Perspective of Qi and Blood

作　　者：陈远亮 朱健敏[1] 陈炜[2] 张金枝 吴林[1] CHEN Yuan-liang;ZHU Jian-min;CHEN Wei;ZHANG Jin-zhi;WU Lin(Guangxi University of Traditional Chinese Medicine,Nanning 530001,China;The First Affiliated Hospital,Guangxi University of Traditional Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院,广西南宁530001

出　　处：《云南中医中药杂志》2024年第10期11-14,共4页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：国家自然科学基金项目(82060844);广西中医药大学一流学科开放课题(2019XK018);广西高等学校高水平创新团队及卓越学者计划(桂教人才(2020)6号);广西中医药大学第一附属医院学术团队建设项目(院字〔2018〕146号);广西中医脑病临床研究中心项目(桂科AD20238028);广西中医药重点学科建设项目(GZXK-Z-20-13)。

摘　　要：历代医家多认为围绝经期抑郁症为女子天癸不足,肾气虚弱,肝肾同源,肾虚肝郁,多从脏腑辨证,而处方用法多以疏肝理气为主。吴林教授认为更年期抑郁症患者,初期使用疏肝解郁之法,可初期短期取得疗效,但在后期患者会因肝气疏泄太过而出现不寐加重,甚至烦躁不安等症状加重的问题。吴林教授经过长期的临床实践,认为围绝经期抑郁症有其性别的特异性,可从气血辨证论治本病,女子以血为本,气能生血,血能养气,步入中老年月水逐渐枯竭,阳气亦随之衰减,阳衰神颓,心神不宁,气血亏虚或气滞血瘀为加重本病的重要病因。故此病可从气血辨证,以补血行气、活血化瘀等为治疗原则,为治疗本病提供新的治疗思路。Historically,physicians have attributed perimenopausal depression to a deficiency of"Tian Gui"(heavenly essence)in women,resulting in qi deficiency of kidney and liver due to the interconnectedness of the liver and kidney.Traditional diagnosis has been based on organ pattern differentiation,with treatment strategies centered around soothing the liver and regulating qi.However,Professor Wu Lin suggests that although liver-soothing and qi-regulating methods are effective in the early stages of perimenopausal depression,the overuse of these approaches may exacerbate symptoms such as insomnia and even irritability in the later stages due to excessive dispersal of liver qi.Based on a long time of clinical practice,Professor Wu proposes that perimenopausal depression exhibits gender-specific characteristics and can be addressed through the framework of qi and blood differentiation.In women,blood serves as the foundation,with qi generating blood and blood nourishing qi.As women age and menstrual flow gradually ceases,yang energy also diminishes,which leads to a weakening of the spirit and consequently emotional instability and restlessness.Qi and blood deficiency or qi stagnation with blood stasis are critical factors that aggravate this condition.Therefore,treatment strategies emphasize qi and blood differentiation,blood nourishing and qi promotion and blood activation for hemostasis,which offer a novel approach to managing perimenopausal depression.

关 键 词：围绝经期抑郁症 气血辨证 归脾汤加减 

分 类 号：R255.9[医药卫生—中医内科学]