文章摘要
袁书章,薛珂,王诗琦,等.张金生教授运用柴胡桂枝汤治疗抑郁症经验探析[J].浙江中医药大学学报,2021,(5):526-529.
张金生教授运用柴胡桂枝汤治疗抑郁症经验探析
Professor ZHANG Jinsheng's Experience in Treating Depression with Chaihu Guizhi Decoction
投稿时间:2020-07-11  
DOI:10.16466/j.issn1005-5509.2021.05.017
中文关键词: 柴胡桂枝汤  抑郁症  阳气不足  少阳不升  气血失和  张金生  医案  名医经验
英文关键词: Chaihu Guizhi decoction  depression  deficiency of Yang Qi  Shaoyang failing to rise  disharmony of Qi and blood  ZHANG Jinsheng  medical records  experience of famous doctors
基金项目:河南中医药传承与创新人才工程(仲景工程)(豫中医科教[2018]25号)
作者单位E-mail
袁书章 河南中医药大学 郑州 450046  
薛珂 河南中医药大学 郑州 450046  
王诗琦 河南中医药大学 郑州 450046  
张金生 河南中医药大学第三附属医院 zjssir2004@sina.com 
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中文摘要:
      [目的]探讨张金生教授运用柴胡桂枝汤治疗抑郁症的经验。[方法]通过跟师临诊,记录和整理张金生教授运用柴胡桂枝汤治疗抑郁症的医案,并结合中医典籍及现代文献研究,从柴胡桂枝汤所主抑郁症的病因病机及其方义探微分析总结张金生教授辨证治疗抑郁症的临床经验,并附验案一则。[结果]张金生教授认为,抑郁症的病因病机和临床症状多与少阳阳气不足相关,并认为少阳阳气虚弱、营卫气血失和是抑郁症发病之本,三焦气化失司,病理产物痰饮、瘀血阻滞为致病之标,主张以和解少阳、调畅气血为主要治法,兼顾开窍化痰、活血化瘀。而少阳阳气虚弱、营卫不和也是柴胡桂枝汤证的病机关键,与抑郁症病机符合,因此张教授临证选用柴胡桂枝汤加减治疗抑郁症。所附医案,张教授辨为心胆阳虚、气血失和,治疗用柴胡桂枝汤加减,取得较好效果。[结论]张金生教授治疗抑郁症,紧扣“少阳阳气不足、营卫气血失和”的病机,运用柴胡桂枝汤加减以和少阳、畅气机、调营卫、化痰浊,可有效改善患者生活质量,为临床治疗拓展了思路。
英文摘要:
      [Objective] To explore Professor ZHANG Jinsheng's experience in treating depression with Chaihu Guizhi decoction.[Methods]Through learning from the teacher,recording and sorting out the medical case of Professor ZHANG Jinsheng's application of Chaihu Guizhi decoction in the treatment of depression,combining with relevant ancient books and modern literature research,the etiology and pathogenesis of depression in Chaihu Guizhi decoction were discussed, it analyzed and summarized Professor ZHANG Jinsheng's clinical experience in the treatment of depression based on syndrome differentiation,and a medical record was attached.[Results]Professor ZHANG Jinsheng finds that the etiology, pathogenesis and clinical symptoms of depression are mostly related to the deficiency of Yang Qi in Shaoyang, and believes that the weakness of Yang Qi in Shaoyang and the disharmony of Qi and blood of Ying and Wei are the root causes of depression. The abnormal Qi activity of tri-Jiao, and the block of pathological products phlegm and blood stasis are the manifestation of the disease. It is suggested that the main therapeutic methods should be reconciling Shaoyang and regulating Qi and blood, opening orifices and dissipating phlegm, and promoting blood circulation to remove blood stasis. Deficiency of Yang Qi in Shaoyang and the disharmony of Ying and Wei are also the key pathogenesis of syndrome of Chaihu Guizhi Decoction, which is consistent with the pathogenesis of depression. Therefore, Professor ZHANG uses modified Chaihu Guizhi Decoction to treat depression. The attached medical record was differentiated as deficiency of heart and gallbladder Yang and disharmony of Qi and blood, Chaihu Guizhi decoction was used for treatment and good results were achieved.[Conclusion] Professor ZHANG Jinsheng's treatment of depression adheres to the pathogenesis of “deficiency of Yang Qi in Shaoyang and disharmony of Qi and blood in Ying and Wei”. The application of Chaihu Guizhi Decoction in the treatment of depression can harmonize Shaoyang, adjust activity of Qi, regulate Ying and Wei and resolve phlegm turbidity, and effectively improve the quality of life of patients and expand the thinking for clinical treatment.
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