四川中医2025，Vol.43Issue(12)：38-44,7.DOI:10.26946/j.cnki.1000-3649.sczy.2508180001
基于"因病致郁、因郁致病"理论探讨气血要素下卒中后抑郁的辨治
Exploration of syndrome differentiation and treatment of post-stroke depression based on the theories of"Yu due to illness"and"illness caused by Yu"
摘要
Abstract
Post-stroke depression(PSD)as a common mental complication following stroke,whose occurrence and progression of which profoundly reflect the interaction between the traditional Chinese medicine(TCM)theories of"Yu due to illness"and"illness caused by Yu".Based on the theories,this illustrative case report proposes that the disharmony of Qi and blood is the core pathogenesis central to the vicious cycle of"disease-depression-disease"in PSD.Stroke(disease)leads to reversed flow of Qi and blood and malnourishment of the mental faculty,thereby inducing depression(Yu),whereas the persistent depressive state(Yu)aggravates the stagnation of Qi movement and obstruction of blood vessels,consequently leading to the recurrence or worsening of stroke(disease).To address this cycle,this illustrative case report constructs a staged diagnosis and treatment framework for PSD guided by the principle of regulating Qi and blood:In the early stage,characterized mainly by liver Qi stagnation or static blood blocking collaterals,treatment focuses on soothing the liver to regulate Qi,and promoting blood circulation to remove obstruction in collaterals,so as to regulate the Qi movement.In the middle stage,dominated by Qi depression transforming into fire or intermingled phlegm and blood stasis,the emphasis shifts to clearing heat and resolving phlegm,eliminating stasis and relieving depression to resolve the congelation.In the late stage,where Qi and blood are both affected,manifesting as stagnation of Qi and blood stasis,blood stasis due to Qi deficiency,or deficiency of both Qi and blood,the therapeutic principle prioritizes tonifying Qi and nourishing blood,harmonizing Qi and blood to reinforce healthy Qi.Through staged treatment based on syndrome differentiation and simultaneous regulation of Qi and blood,this illustrative case report aims to provide a theoretical basis and a systematic approach for breaking the vicious cycle of PSD and improving its TCM diagnosis and treatment strategies.关键词
卒中后抑郁/因病致郁/因郁致病/气血失和Key words
Post-stroke depression/Yu due to illness/Illness caused by Yu/The disharmony of Qi and blood分类
医药卫生引用本文复制引用
LI Jie,ZHANG Xiaole,CAO Yongdan,DUAN Lunhui,ZHAO Yuanjiang,LIU Huan,HAN Zucheng..基于"因病致郁、因郁致病"理论探讨气血要素下卒中后抑郁的辨治[J].四川中医,2025,43(12):38-44,7.基金项目
国家中医药管理局韩祖成全国名老中医药专家传承工作室项目(国中医药人教函[2022]75号) （国中医药人教函[2022]75号）
西安市科技计划项目(24YXYJ0151) （24YXYJ0151）
铜川市中医药传承创新发展示范试点项目(SXM20241116-01) （SXM20241116-01）
陕西省中医药管理局项目(SZY-KJCYC-2025-LC-013). （SZY-KJCYC-2025-LC-013）
