基于"心气虚则悲"分期论治卒中后抑郁OA北大核心CSTPCD

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.