| 娄蒙萍,郭静,张芯,等.郁证的脏腑分型治疗探析[J].浙江中医药大学学报,2021,45(6):607-611. |
| 郁证的脏腑分型治疗探析 |
| Discussion on Viscera Classification Treatments of Depression Syndrome |
| DOI：10.16466/j.issn1005-5509.2021.06.007 |
| 中文关键词: 心郁 脾郁 肝郁 胆郁 肾郁 肺郁 脏腑辨证 情志病 |
| 英文关键词: heart depression spleen depression liver depression gallbladder depression kidney depression lung depression syndrome differentiation of viscera emotional diseases |
| 基金项目:国家自然科学基金项目(81904100)；浙江省中医药科技计划项目(2019ZA100) |
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| 中文摘要: |
| [目的]从脏腑分型角度探析郁证的病因病机及证治。[方法]深入分析历代医籍及近现代中医名家治疗郁证的方药应用，以脏腑为纲，分型探讨郁证的临床诊疗。[结果]郁证大体可分为心郁、脾郁、肝郁、胆郁、肾郁、肺郁6类，根据各脏腑生理病理特点，心郁又可分为心气实与心气虚，心气实者治宜选用黄连阿胶汤加减，心气虚者可予甘麦大枣汤加减；脾郁以振奋脾气为要，治宜小建中汤加减，以建中气；肝郁可分肝气实与肝血虚寒，肝气实予逍遥散加减，肝血虚寒予暖肝煎加减；胆郁可分胆气虚寒与胆经湿热，胆气虚寒可予温胆汤加减，胆经湿热可予蒿芩清胆汤加减；肾郁的治疗当以补冲任、固精血、降火气为法，可予二仙汤加减；肺郁的治疗当以清肺生津、滋阴润燥为法，可予百合知母汤加减。[结论]脏腑皆藏气血，五脏各有其志，治疗郁证不应单以疏肝解郁为法，当随脏腑之志，分脏而治。 |
| 英文摘要: |
| [Objective] To explore the etiology， pathogenesis and treatment of depression syndrome from the perspective of viscera classification. [Methods] Through analyzing the prescriptions of ancient medical records and modern Chinese medicine experts in treating depression syndrome and taking the viscera as the outline， the clinical diagnosis and treatment of depression syndrome are discussed. [Results] There are six kinds of depression syndrome. Heart depression， spleen depression， liver depression， gallbladder depression， kidney depression and lung depression. According to the physiological and pathological characteristics of viscera， heart depression can be divided into excess of heart Qi and deficiency of heart Qi， modified Huanglian Ejiao Decoction can be selected to treat patients who belong to excess of heart Qi; modified Ganmai Dazao Decoction can be selected for patients of deficiency of heart Qi. Patients of spleen depression can select modified Xiaojianzhong Decoction seizing the point of enhancing the spleen Qi. Liver depression can be divided into excess of liver Qi and deficiency and cold of liver blood， patients of excess of liver Qi can be treated by modified Xiaoyao Powder; patients of deficiency and cold of liver blood can be treated by modified Nuangan Decoction. Gallbladder depression can be divided into deficiency and cold of gallbladder Qi and dampness and heat of gallbladder， patients of deficiency and cold of gallbladder Qi can be treated by modified Wendan Decoction; patients of dampness and heat of gallbladder can be treated by modified Haoqin Qingdan Decoction. The treatment of kidney depression should be based on tonifying Chongren， strengthening the essence and blood， reducing fire， and modified Erxian Decoction can be adopted. The treatment of lung depression should be based on clearing the lung and promoting fluid， nourishing Yin and moistening dryness， and modified Baihe Zhimu Decoction can be selected. [Conclusion] Qi and blood are stored in the viscera， and each of the five viscera has its own will. The treatment of depression should not only be based on soothing the liver and relieving depression， but should be treated according to the respective will of the viscera. |
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