河南中医2025，Vol.45Issue(8)：1192-1197,6.DOI:10.16367/j.issn.1003-5028.2025.08.0194
从"滞、郁、虚"论治抑郁症
On Treating Depression from the Perspectives of"Stagnation and Constraint and Deficiency"
摘要
Abstract
The pathogenesis of depression centers on"stagnation,constraint,and deficiency,"with qi stagnation as the primary contra-diction.Stagnation manifests as"excess stagnation"and"deficiency stagnation".The pathogenesis of"excess stagnation"is qi stagna-tion,so the formula composition focuses on soothing the liver and moving qi as the sovereign drugs,supplemented by nourishing liver yin and blood.Liver depression is prone to invading the spleen-earth,thus,drugs for fortifying the spleen and supplementing qi serves as the minister herbs,aided by aromatic dampness-resolving agents.Wind drugs act as assistants to enhance liver-soothing and spleen-fortifying effects.Qi constraint may further lead to other stagnation pathologies(that is,five types of stagnation except qi stagnation),requiring corresponding resolutions like activating blood,resolving phlegm,digesting food,clearing fire,or eliminating dampness.Deficiency stag-nation arises from insufficiency of qi,blood,yin,or yang.Treatment focuses on supplementation.For qi-blood deficiency,drugs for tonify-ing heart-spleen qi and blood act as the sovereign drugs.The spleen and stomach,as the source of qi-blood production,necessitates forti-fying the spleen,supplementing qi,resolving dampness,and regulating spleen-stomach ascent and descent as ministers.Qi-moving drugs assist to prevent supplementation-induced stagnation,while wind drugs uplift clear yang and disperse qi constraint.For yin-yang defi-ciency,drugs for-tonifying yin and yang serve as sovereigns,applying the principle of"seeking yin within yang,and yang within yin."Yang deficiency easily causes fluid retention;thus,drugs for dredging yang and resolving dampness are ministers.Yin deficiency gener-ates internal heat,requiring heat-clearing and fire-draining ministers.Qi-moving drugs prevent cloying stagnation of yin-nourishing a-gents and ensure thorough penetration of yang-warming drugs.As the kidney is the fundamental root of yin and yang in the body,the core of tonifying yin and yang should be tonifying the kidney.Finally,depression itself is a mental illness,so whether it is"solid stagna-tion"or"deficiency stagnation",it should be accompanied by drugs that relieve depression and calm the mind to treat its symptoms;Long-term illness can cause blood stasis,so prolonged depression should be accompanied by drugs that promote blood circulation and unblock channels.关键词
抑郁症/滞/郁/虚/"实滞"/"虚滞"/从肝论治/从心论治/从脾论治/从肺论治/从肾论治/风药分类
医药卫生引用本文复制引用
李佳伦..从"滞、郁、虚"论治抑郁症[J].河南中医,2025,45(8):1192-1197,6.基金项目
四川省自然科学基金青年基金项目(2024NSFSC1829) （2024NSFSC1829）
