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张永华情志辨证体系的构建及临床应用

ZHANG Yonghua's Theory of Emotion-Mind Pattern Differentiation and Clinical Application

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系统阐述张永华教授情志辨证体系的构建背景、情志辨证的理论基础、辨证及临床应用思路.情志辨证体系以形神一体观为指导,注重个体禀赋及个性的七情五志特征,着重把握"烦、郁、虑、惊、悲"情志症状,谨守"气、痰、火"三大核心病机,随证立法施药,适宜用于情志疾病和情志相关疾病.以"火"为主要病机者,辨情志表现,急躁、暴怒者,多属实火,以栀子豉汤、龙胆泻肝汤治疗;心烦、善怒者,多属虚火,以黄连阿胶汤治疗;心烦、愠怒者,多属郁火,以丹栀逍遥散、芩连温胆汤为主治疗;以过喜为情志表现者,常为心火亢盛或痰蒙心包,用温胆汤或癫狂梦醒汤治疗.以"痰"为主要病机者,常有多虑多思情志表现,以温胆汤为主治疗.以"气"为主要病机者,病程较短者以甘麦大枣汤为主,日久则以半夏厚朴汤为主治疗.
This article systematically described the background of the construction of Professor ZHANG Yonghua's theory of emotion-mind pattern identification,the theoretical basis and the ideas of pattern identification and treatment,and its application.The theory is guided by the concept of the unity of body and spirit,focusing on individual endow-ment and the characteristics of the seven emotions and five minds of the individual,especially the"vexation,constraint,consideration,frightening and sorrow"emotional symptoms,and adherence to the three core disease mechanism"qi,phlegm,fire",then prescribed based on the patterns,which is suitable for treatment of emotion-mind diseases and re-lated symptoms.For those with"fire"as the main disease mechanism,identify the manifestation of their emotion and mind:patients with impatience,violent rage mostly belong to excess fire,treated with Zhizi Chi Decoction(栀子豉汤),Longdan Xiegan Decoction(龙胆泻肝汤);patients with vexation,easy to anger,mostly belong to deficiency fire,treated with Huanglian Ejiao Decoction(黄连阿胶汤);patients with vexation,constraint anger,mostly belong to con-straint fire,treated with Danzhi Xiaoyao Powder(丹栀逍遥散),Qinlian Wendan Decoction(芩连温胆汤);patients with overjoy,usually due to exuberance of heart fire,or phlegm clouding the pericardium,treated with Wendan Decoction(温胆汤),or Diankuang Mengxing Decoction(癫狂梦醒汤).For those with"phlegm"as the main disease mechanism,accompanied by excessive consideration and thinking,treated with Wendan Decoction.For those with"qi"as the main disease mechanism,Ganmai Dazao Decoction(甘麦大枣汤)is the main treatment for shorter duration of disease,while Banxia Houpo Decoction(半夏厚朴汤)is the main treatment for longer duration of disease.

emotion-mind pattern differentiationemotion and mind symptomsqiphlegmfireexperience of famous doctorsZHANG Yonghua

胡霖霖、张芯、张永华

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浙江中医药大学附属杭州市中医院,浙江省杭州市西湖区体育场路453号,310007

浙江中医药大学药学院

情志辨证 情志症状 名医经验 张永华

国家自然科学基金浙江省中医药科技计划全国老中医药专家学术经验继承工作项目(第七批)

822050002022ZB246国中医药人教函[2022]76号

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(8)
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