《景岳全书》命门神志理论在抑郁症论治中的应用  

Discussion on the treatment of depression based on the mingmen-shenzhi theory of Jing Yue Quan Shu

作　　者：刘炀 张雨晴 沈金涛 李良松 LIU Yang;ZHANG Yuqing;SHEN Jintao;LI Liangsong(School of Chinese Classics,Beijing University of Chinese Medicine,Beijing 100029)

机构地区：[1]北京中医药大学国学院,北京100029

出　　处：《现代中医临床》2025年第2期102-106,共5页Modern Chinese Clinical Medicine

基　　金：国务院台湾事务办公室台湾中医药研究基地建设项目(No.GTB2017-170)。

摘　　要：中医学对于抑郁症的治疗有独特的优势,文章以《景岳全书》论述为基础,结合西医学,探讨抑郁症的辨治理论。研究结果表明,《景岳全书》的命门神志理论对于抑郁症的辨治有着重要启示意义。抑郁症的病因为外受负性刺激,内伤命门元阳,致神志调节能力失衡,情绪持久低落。病机为命门元阳不足,七情内伤。在治疗上,应紧扣病机,以培补命门真元为本,根据脏腑精气亏虚的不同,有选择性的疏调七情,培补五脏。在用药上注重温补,强调攻补兼施,避免过用疏解克伐之品败伤脏气。同时对于抑郁症所伴随的进食、睡眠、性功能等躯体症状障碍,有针对性的进行辨证论治。此外,还应重视心理调节,增强抑郁症患者的负面情绪调节能力。Traditional Chinese Medicine offers unique advantages in treating depression. This paper discusses the differentiation and treatment theory of depression based on the Jing Yue Quan Shu(The Complete Works of [Zhang] Jing-yue) and modern medicine. The results show that the mingmen(gate of vitality)-shenzhi(the conscious mind) theory proposed in the book has important implications for the differentiation and treatment of depression. This disease is caused by a combination of external negative stimuli and internal injury to the original yang of mingmen, which result in an imbalance in the ability to regulate one's mind. This often manifests as persistent low moods. The pathogenesis of depression is caused by internal emotional injury and the deficiency of original yang of mingmen. In treatment, it is important to focus on the pathogenesis, nourish the original yang as the foundation, selectively regulate the seven emotions and nourish the five zang organs based on the deficiency status of each of them. For the selection of herbs, attention should be paid to warming and tonifying and a combined use of the attacking and supplementing methods, and caution should be taken to avoid damaging organ qi with dispersing and purging ingredients. Additionally, targeted differentiation and treatment should be given to physical symptoms such as eating disorders, sleep disorders, and sexual dysfunction associated with depression. In addition, psychological regulation should be emphasized to enhance the negative emotion regulation ability of patients with depression.

关 键 词：景岳全书 抑郁症 中医药 治疗 命门 

分 类 号：R277.7[医药卫生—中医学]