| 庄子凡,续冠胜,王诗源.临床活用金匮思维治疗情志类疾病体会[J].浙江中医药大学学报,2021,45(8):911-915. |
| 临床活用金匮思维治疗情志类疾病体会 |
| Clinical Experiences in Treating Emotional Diseases with Thinking in “Synopsis of The Golden Chamber” |
| DOI：10.16466/j.issn1005-5509.2021.08.017 |
| 中文关键词: 甘麦大枣汤 产后抑郁症 黄芪桂枝五物汤 不宁腿综合征 瓜蒌薤白桂枝汤 更年期焦虑症 竹皮大丸 神经性呕吐 |
| 英文关键词: Ganmai Dazao decoction postpartum depression Huangqi Guizhi Wuwu decoction restless leg syndrome Gualou Xiebai Guizhi decoction climacteric anxiety Bamboo-skin neurological vomiting |
| 基金项目:山东省专业学位研究生教学案例库建设项目(SDYAL18029)；山东省自然科学基金项目(ZR2020MH352) |
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| 中文摘要: |
| [目的]介绍运用《金匮要略》诊疗思维治疗情志异常类病证的体会。[方法]选取4例情志异常类病证经方治疗验案，根据患者的主要症状体征与其情志异常症状进行综合辨证，总结应用《金匮要略》经方治疗情志异常类病证的经验。[结果]病案一根据患者“悲伤欲哭”的主要临床表现，结合《金匮要略》中“邪哭”“脏躁”的诊疗思维，辨证选用桂枝加龙骨牡蛎汤合甘麦大枣汤加减治疗产后抑郁症，收效迅捷；病案二根据患者“卧起不安”的主要临床表现，结合《金匮要略》中“血痹”“百合病”的诊疗思维，辨证选用黄芪桂枝五物汤合百合地黄汤加减治疗不宁腿综合征，疗效良好；病案三根据患者“胸闷灼热不适”的主要临床表现，结合《金匮要略》中“肝着”“胸痹”的诊疗思维，辨证选用瓜蒌薤白桂枝汤、茯苓杏仁甘草汤合旋覆花汤加减治疗更年期焦虑症，收效颇佳；病案四根据患者“烦躁不欲饮食”“食后呕吐”的主要临床表现，结合《金匮要略》中“产后呕逆”诊疗思维，辨证选用竹皮大丸合一贯煎制蜜丸治疗神经性呕吐，月余痊愈。[结论]临床活用金匮思维治疗情志异常类病证，即遵“但见一证便是，不必悉具”的原则，将此类病症的典型症状与《金匮要略》中相关的方证条文结合起来思考，辨证选用《金匮要略》中的经方如甘麦大枣汤、百合地黄汤、旋覆花汤、竹皮大丸等进行治疗，并须综观脉证，知犯何逆，合理加减配伍，方可获良效。 |
| 英文摘要: |
| [Objective]To introduce the experience of treating the syndromes of emotional diseases with the clinical thinking in “Synopsis of the Golden Chamber”.[Methods]Four cases of syndromes with abnormal emotions treated by the classical prescription were selected， and the syndrome differentiation was carried out based on the main symptoms and signs of the patients and the syndrome of abnormal emotions， and the experience of treating syndromes with the classical prescription in “Synopsis of the Golden Chamber” was summarized.[Results] According to the main clinical manifestations of “sadness and tears” in case one， combined with the diagnosis and treatment thinking of “evil cry” and “viscera and manic disorder” in “Synopsis of the Golden Chamber”， Guizhi plus Longgu Muli decoction and Ganmai Dazao decoction were selected to treat postpartum depression according to syndrome differentiation， with rapid results. According to the main clinical manifestations of “restless sleeping” in case two， combined with the “blood arthralgia” and “disease of all vessels” diagnosis and treatment thinking in “Synopsis of the Golden Chamber”， Huangqi Guizhi Wuwu decoction and Baihe Dihuang decoction were selected for treatment of restless leg syndrome with good curative effect.According to the main clinical manifestations of “chest distress and discomfort”， combined with the diagnosis and treatment thinking of “liver pain” and “chest arthralgia” in “Synopsis of the Golden Chamber”， the climacteric anxiety of case three was treated by selecting Gualou Xiebai Guizhi decoction， Fuling Xingren Gancao decoction and Xuanfuhua decoction according to syndrome differentiation， which achieved good results.According to the main clinical manifestations of “irritable not to eat” and “vomiting after food” of case four， combined with the “post-partum vomiting” diagnosis and treatment thinking in “Synopsis of the Golden Chamber”， Bamboo-skin Large Bolus and Yiguan decoction honey pill were selected to treat neurological vomiting according to syndrome differentiation， and the patient recovered in one month.[Conclusion]The application of classical prescriptions in “Synopsis of the Golden Chamber” in the treatment of emotional diseases based on syndrome differentiation is of great significance to the clinical diagnosis and treatment of emotional diseases. |
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