基于系统辨证脉学辨治心理紊乱状态下抑郁症  

Differentiation and treatment of depression in the state of psychological disturbance based on systematic identification of the pulse

作　　者：高豪男 衣云昊 滕晶 GAO Haonan;YI Yunhao;TENG Jing(The First Clinical College of Shandong University of Traditional Chinese Medicine,Jinan 250014)

机构地区：[1]山东中医药大学第一临床医学院,济南250014

出　　处：《现代中医临床》2025年第2期14-18,共5页Modern Chinese Clinical Medicine

基　　金：山东省中西医结合专病防治项目(No.YXH2019ZXY006);山东省中医药科技项目(No.Z-2022094T,No.Z-2022087T);国家中医药管理局第五批全国中医临床优秀人才研修项目(No.国中医药人教函[2022]1号);齐鲁医派中医学术流派传承项目(No.鲁卫函[2022]93号)。

摘　　要：中医学将抑郁症归属于“郁证”范畴。系统辨证脉学以系统论为基础,对脉象机制、要素等信息进行多学科、多领域解析,继承并创新性地提出25对“脉象要素”。“中医心理紊乱状态”理论将中医脏腑辨证体系与心理学原理相结合。心理紊乱状态下抑郁症的病因病机主要包括:惊悸不安状态、郁闷不舒状态、精神萎靡状态、思虑过度状态和烦躁焦虑状态。不同心理紊乱状态下抑郁症的脉象特征和治法分别为:惊悸不安状态下抑郁症的脉象特征为刚、敛、疾、直、指感有麻手感,治以镇静安神、宁心养血;郁闷不舒状态下抑郁症的脉象特征为动、涩、沉、短、缓,治以疏肝解郁、理气活血;精神萎靡状态下抑郁症的脉象特征为脉来去怠缓、深、短、弱,治以益气补血、振奋阳气;思虑过度状态下抑郁症的脉象特征为内曲、怠、涩、细,治以行气开郁、解思除虑;烦躁焦虑状态下抑郁症的脉象特征为脉搏起始段急促、动、数、高;治以除烦安神、平肝潜阳。并结合临床案例对基于系统辨证脉学辨治心理紊乱状态下抑郁症进行阐述。Traditional Chinese Medicine(TCM) classifies depression within the realm of Yuzheng(stagnation syndrome). The “Systematic Identification of the Pulse” is based on systems theory, analyzing the mechanisms and elements of pulse manifestations through multidisciplinary and multi-domain approaches, inheriting and innovatively proposing 25 pairs of “pulse elements”. The “Psychological Disordered State in TCM” combines the TCM organ diagnostic system with psychological principles. The pathogenesis of depression in the state of psychological disturbance includes states of fright, gloom, listlessness, overthinking, and irritability-anxiety. The pulse characteristics and treatment method for depression under different psychological disordered state are as follows: the pulse characteristics of the frightstate are rigid, tense, rapid, straight, and a numb feeling upon palpation, and the treatment is to calm the mind and nourish blood;the pulse characteristics of gloomstate are erratic, rough, deep, short, and slow, and the treatment is to soothe the liver, alleviate stagnation, and promote qi and blood flow;the pulse characteristics of the listlessness state are slow and sluggish pulse, deep, short, and weak, and the treatment is to boost qi and blood, invigorate yang;the pulse characteristics of overthinking state are internal bending, sluggish, rough, and thin, and the treatment is to promote qi and relieve stagnation, resolve overthinking;the pulse characteristics of irritability-anxiety state are rapid onset, erratic, rapid, and high, and the treatment is to relieve irritability and calm the mind, pacify the liver and suppress yang. Furthermore, clinical cases are used to illustrate the diagnosis and treatment of depression under psychological disturbance based on the Systematic Identification of the Pulse.

关 键 词：系统辨证脉学 中医心理状态 心理紊乱状态 脉—针—药 抑郁症 

分 类 号：R241.1[医药卫生—中医诊断学] R259[医药卫生—中医临床基础] R229[医药卫生—中医学]