从心主血脉探讨冠心病合并抑郁“瘀虚致郁”病机  

Pathogenesis of Coronary Heart Disease Combined with Depression from Perspective of Heart Dominating Blood and Blood Vessel

作　　者：丁婉丽 邵葭琳 赵海滨[1,2] 王昀 孙治琪 赵维哲 刘祥 郜亚茹 王俊清 DING Wanli;SHAO Jialin;ZHAO Haibin;WANG Yun;SUN Zhiqi;ZHAO Weizhe;LIU Xiang;GAO Yaru;WANG Junqing(Beijing University of Chinese Medicine,Beijing China 100029;Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing China 100078;Shunyi Hospital of Beijing TCM Hospital,Beijing China 101300)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]北京中医医院顺义医院,北京101300

出　　处：《中医学报》2024年第12期2522-2528,共7页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82174332);北京中医药大学基本业务费揭榜挂帅项目(2022-JYB-JBZR-002)。

摘　　要：心主血脉主要包含了心主血和心主脉的功能,贵在“通、荣”,若发生病变,则在“瘀、虚”。心主血脉是心主神明的生理基础,心主血脉功能受损,可波及心主神明。“瘀虚致郁”是双心疾病之冠心病合并抑郁的重要病机。冠心病合并抑郁中“瘀”的中医病机与西医血管内皮功能损伤、血小板功能障碍、脂质代谢异常等现代机制具有相关性;“虚”的中医病机与西医线粒体能量代谢障碍具有相关性。基于“瘀虚致郁”的重要病机,治疗冠心病合并抑郁应以祛瘀通郁、补虚固本为治疗大法。Heart dominating blood and the blood vessel,the most valuable point of which is the"circulation and nourishment"and the ailment of which would be"stasis and deficiency".Heart dominating blood and blood vessel is the physiological foundation of the Heart dominating spirit,and the injury to the former can affect the latter."Stasis and deficiency induced depression"is an important pathogenesis of coronary heart disease combined with depression of the psycho-cardiological disease.The Chinese medicine mechanism of"stasis"in coronary heart disease combined with depression has correlation with the modern mechanism of vascular endothelial function damage,platelet dysfunction,and lipid metabolism abnormality in western medicine;the Chinese medicine mechanism of"deficiency"has correlation with the mitochondrial energy metabolism disorder in western medicine.Based on the important mechanism of"stasis and deficiency induced depression",the treatment of coronary heart disease combined with depression should be dispelling stasis and relieving depression as well as tonifying the deficiency to consolidate the root aspect of man′s health.

关 键 词：冠心病 抑郁 心主血脉 “瘀虚致郁” 双心疾病 

分 类 号：R256.22[医药卫生—中医内科学]