基于时脏理论辨治卒中后抑郁  

Differentiation and Treatment of Post-Stroke Depression Based on the Theory of Season-Visceral-Related

作　　者：姜宇 莫梦婷 张圆 张春阳 常念 马一昕 张綦慧[1] JIANG Yu;MO Mengting;ZHANG Yuan;ZHANG Chunyang;CHANG Nian;MA Yixin;ZHANG Qihui(Department of Neurology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院脑病科,北京市100078

出　　处：《实用心脑肺血管病杂志》2025年第6期92-95,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：中央高水平中医医院临床科研业务费资助项目(DFRCZY-2024GJRC005)。

摘　　要：时脏理论最早见于《素问·金匮真言论》,体现了中医“天人相应”“五脏一体”的思想。卒中后抑郁(PSD)虽病位在脑,但与五脏密切相关。本文基于时脏理论将春、夏、长夏、秋、冬季节PSD病因病机分别概括为肝气郁结、气机不畅,心血不足、神失所养,脾失健运、痰气郁结,肺气虚、肺失肃降及肾精不足、脑失所养,并对应指出春宜疏肝理气以解郁、夏宜养血安神以理郁、长夏宜健脾化痰以开郁、秋宜补肺理气以通郁、冬宜补肾填精以化郁的治疗原则,这可为临床防治PSD提供理论参考。The season-visceral-related theory originates from the Jingui Zhenyan Lun in Suwen,it reflects the concepts of"correspondence between nature and human"and"holism of the five Zang organs"in traditional Chinese medicine(TCM).Although post-stroke depression(PSD)is located in the brain,it is closely related to the five Zang-organs.Based on the theory of season-visceral-related,this article summarizes the etiology and pathogenesis of PSD in spring,summer,long summer,autum,winter as liver Qi stagnation and poor smoothness of Qi circulation,insufficiency of heart blood,lost in spirit,dysfunction of spleen in transportation,phlegm Qi stagnation,deficiency of lung Qi,disorder of Qi in ascending and descending,as well as insufficiency of kidney essence and deficiency of brain nutrient,respectively.Therefore,this article points out that since spring is characterized by generation,patients should be treated by soothing the liver and regulating Qi to relieve Qi stagnation.Summer is characterized by growth,patients should be treated by nourishing the blood and calming the spirit to regulate Qi stagnation.Long summer is characterized by transformation,patients should be treated by invigorating the spleen and resolving phlegm to expel Qi stagnation.Autumn is characterized by harvest,patients should be treated by tonifying the lung and regulating Qi to remove Qi stagnation.Winter is characterized by storage,patients should be treated by tonifying the kidney and supplementing essence to transform Qi stagnation.This can provide theoretical reference for clinical prevention and treatment of PSD.

关 键 词：抑郁 卒中后抑郁 时脏理论 

分 类 号：R749.42[医药卫生—神经病学与精神病学]