基于"心气虚则悲"分期论治卒中后抑郁
Staged treatment of post-stroke depression based on"deficiency of heart qi leading to sadness"
孙逸龙 1宋研博 1徐方飚 1吴易俊 1胡雨荷 2孙永康 3余欢 1王怡娜 1王新志3
作者信息
- 1. 河南中医药大学第一附属医院脑病中心 郑州 450099;河南中医药大学第一临床医学院
- 2. 河南中医药大学第一临床医学院
- 3. 河南中医药大学第一附属医院脑病中心 郑州 450099
- 折叠
摘要
卒中后抑郁是脑卒中后常见的并发症.本团队根据《黄帝内经》中记载的"心气虚则悲",提出心气虚为卒中后抑郁的基本病机,悲为其主要表现,故从心论治卒中后抑郁,临床可分为心肝期、心肺期、心脾期、心肾期.以调气补心为卒中后抑郁的治疗原则,心肝期、心肺期的卒中后抑郁患者以中青年居多,病性多属实,心虚不甚,当以通经调气为法;心脾期、心肾期的卒中后抑郁患者多见于中老年,病性多属虚,心气亏虚较重,当以补益为要.针对以上 4 期,本团队临证分别予逍遥散、百合地黄汤、甘麦大枣汤、金匮肾气丸治疗,临床疗效较好.本文以从心论治卒中后抑郁的中西医理论基础、卒中后抑郁的基本病机与分期、调气补心的治疗原则 3 个层面立论,探讨从"心气虚则悲"论治卒中后抑郁的诊疗思路,浅析治疗本病的临床用药经验,以期为治疗卒中后抑郁提供参考.
Abstract
Post-stroke depression is a common complication after a stroke.Based on the theory of"deficiency of heart qi leading to sadness"recorded in Huangdi Neijing,our team proposes that deficiency of heart qi is the basic pathogenesis of post-stroke depression,with sadness being its main manifestation.Therefore,we advocate treating post-stroke depression from the perspective of the heart,and clinically,it can be divided into four stages:heart-liver stage,heart-lung stage,heart-spleen stage,and heart-kidney stage.Treating post-stroke depression with the principle of regulating qi and nourishing the heart,patients in the heart-liver and heart-lung stages are mainly middle-aged and young adults,with a pathological nature of qi stagnation and mild deficiency of heart qi,and therefore,the method of promoting the flow of meridians and regulating qi should be adopted.In contrast,patients in the heart-spleen and heart-kidney stages are mainly middle-aged and elderly,with a pathological nature of qi deficiency and severe deficiency of heart qi,and therefore,nourishment and tonification should be prioritized.In response to the above four stages,our team has achieved good clinical efficacy by administering Xiaoyao Powder,Baihe Dihuang Decoction,Ganmai Dazao Decoction and Jingui Shenqi Pill respectively.This study discusses the approach to treating post-stroke depression from the perspective of a"deficiency of heart qi leading to sadness"by examining three aspects:the theoretical basis of Chinese and Western medicine to treat post-stroke depression from the heart,the basic pathogenesis and staging of post-stroke depression,and the treatment principle of regulating qi and nourishing the heart.The study also briefly analyzes the clinical experience of the medications used for this condition to provide a reference for the treatment of post-stroke depression.
关键词
心气虚/心气虚则悲/卒中后抑郁/分期论治/理论探讨Key words
deficiency of heart qi/deficiency of heart qi leading to sadness/post-stroke depression/staged treatment/theoretical discussion引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据