郁热与心郁探微  

A study on the stagnation of heat and depression of heart

作　　者：姜靖茜 陈笑音 逄金晖 周景想 郑昱 赵雅婷 JIANG Jingqian;CHEN Xiaoyin;PANG Jinhui;ZHOU Jingxiang;ZHENG Yu;ZHAO Yating

机构地区：[1]山东中医药大学,山东济南250399 [2]青岛大学附属青岛市海慈医院(青岛市中医医院),山东青岛266033

出　　处：《中医临床研究》2024年第24期116-120,共5页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2021Q056);青岛市医药卫生科研指导项目(2022-WJZD042);青岛市中医药科技项目(2023-zyym01)。

摘　　要：“郁”为停滞、阻塞不通的状态,郁热则为火热之气闭郁在体内。文章基于“郁热”的理论渊源及意义,探讨“郁热”与“心郁”之间关系。在传统的中医理论中,心、血、神之间相互关联。心主生血及行血,血能养神,且中医理论认为“心主神明”,而血为神之舍,是机体神志活动的主要物质基础;而神也能调控心对于周身血液的生成及运行。心和火热的联系十分密切,心病可因火热而生,火热亦可内扰于心。郁热在脏应心,当气机升降异常,导致郁热倾向出现时,心系疾病患者临床症情变化明显。郁热可因五运六气之太过、不及或外感风寒,致心气不舒,而邪热怫郁于内,影响心、血、神从而致病;情志内伤、饮食偏颇、劳逸失度、各种病理产物亦为心系疾病“郁热”的病因,气血运行不畅导致火热之气闭郁在体内的情况为心系疾病“郁热”的基础病机,其表现为心失“通”之性、失“明”之性、失“降”之性。结合心系疾病“郁热”的病因病机及“郁热宜发之”代表方剂升降散、栀子豉汤、四逆散组方特点及典型病案,阐述“心郁”所导致的心系疾病需“发”其“郁”,透其邪气,审因辨治,因势利导、顺势而治,畅达气机,从而使机体恢复“郁开气达”之生理状态。“Stagnation”is a state of stagnation and obstruction.Stagnation of heat is a state of heat,which means the heat is closed in the body.Based on the theoretical origin and significance of“stagnation of heat”,this paper discusses the relationship between“stagnation of heat”and“heart depression”.In the traditional theory of traditional Chinese medicine,the heart,blood and spirit are interrelated.The heart governs the blood production and circulation,and blood can nourish the spirit.According to the theory of traditional Chinese medicine,“The heart controls spirit”,and blood is the offer of the spirit,which is the main material basis of the body’s mental activities;and the spirit can also regulate the generation and circulation of blood around the body.The connection between the heart and the fire-heat-evil is very close.Heart disease can be caused by the fire-heat-evil,and the fire-heat-evil can also disturb the heart.Depression is in the heart.When the abnormal rise and fall of Qi(气)leads to the tendency of stagnation of heat,the clinical condition of patients with heart diseases changes significantly.Stagnation of heat can be caused by the excessiveness or failure of the five movements and six Qi,or the external attack of wind and cold,resulting in uncomfortable heart and Qi,and the evil heat is depressed inside,affecting the heart,blood,and spirit,thus causing disease;emotional internal injury,diet bias,loss of balance between work and rest,and various pathological products are also the causes of the heart disease of“depressive heat”.The poor operation of Qi and blood leads to the heat in the body.The situation is the basic pathological mechanism of the“depressive fever”of the heart disease,and its manifestations are the peculiarities of the loss of“thoroughfare”,the loss of“brightness”,and the loss of“descending”.Combined with the etiology and pathogenesis of the heart disease“depressive fever”,and the characteristics and typical cases of the representative prescrip

关 键 词：郁热 心郁 病因病机 治则治法 代表方剂 

分 类 号：R25[医药卫生—中医内科学]