浙江中医药大学学报2025，Vol.49Issue(12)：1559-1565,7.DOI:10.16466/j.issn1005-5509.2025.12.007
基于络病理论的冠心病伴抑郁证治刍议
Discussion on the Diagnosis and Treatment of Coronary Heart Disease with Depression Based on Collateral Disease Theory
摘要
Abstract
[Objective]Based on the theory of collateral disease,to discuss the characteristics of coronary heart disease with depression,the evolution of pathogenesis at different stages,and its therapeutic principles,in order to provide new ideas for the diagnosis and treatment of coronary heart disease with depression.[Methods]Firstly,the core connotation of collateral disease theory was systematically sorted out,and the characteristics of collateral disease were expounded by combining ancient literature and doctors'discussion.Secondly,from the perspective of collateral disease,the pathogenesis evolution path of coronary heart disease with depression from"deficiency → stasis and toxin → stasis and toxin stagnation"is deeply analyzed.According to the progress of the disease,it is divided into three stages:early stage(mainly collateral deficiency),middle stage(stasis and toxin damage collaterals)and late stage(stasis and toxin stagnation obstructing collaterals and damaging spirit).Combined with the clinical symptoms,pathological characteristics and modern research of each stage,the treatment principles are summarized.Finally,based on the principle of"dredging collaterals for use",the clinical application points of replenishing Qi and nourishing couaterals,removing blood stasis and detoxicating,opening depression and soothing the nerves and other treatment methods and related representative prescriptions are summarized.[Results]The characteristics of collateral disease have mainly two aspects:One is that collaterals are more deficient and easy for stasis,and the longer the time is,the more toxic.The second is that the long-term pathogenic factors go deep into the collaterals and the collaterals damage the spirit.The pathogenesis of coronary heart disease with depression has evolved in stages.In the early stage,the pathogenesis of coronary heart disease with depression begins with the deficiency of collaterals,treated by replenishing Qi and tonifying deficiency,nourishing collaterals and heart with Ginseng Decoction,Zhigancao Decoction and so on.In the middle stage,blood stasis and toxin damaging collaterals are the pathogenesis hub,treated by promoting blood circulation and removing blood stasis,detoxification and dredging collaterals.Xuefu Zhuyu Decoction is used for severe blood stasis,and Huanglian Jiedu Decoction is used for severe toxin.In the later stage,blood stasis and toxin stagnation,obstruction of collaterals and injury of spirit are the pathogenesis outcomes,treated by removing blood stasis,detoxification,opening depression and dredging collaterals.Danshen Decoction and Qingying Decoction are selected,combined with soothing liver and soothing nerves.[Conclusion]The core pathogenesis elements of coronary heart disease with depression are"deficiency,blood stasis,toxin and depression".Over time,it can lead to the pathological state of"deficiency of collaterals,co-occurrence of blood stasis and toxin,accumulation of depression and injury of spirit".The clinical treatment should follow the principle of"collaterals should be unobstructed".关键词
冠心病/抑郁/络病/久病入络/络脉虚损/瘀毒损络/瘀毒郁互结/化瘀解毒开郁分类
医药卫生引用本文复制引用
田梦瑶,王洁宜,楼雅荟,朱爱松..基于络病理论的冠心病伴抑郁证治刍议[J].浙江中医药大学学报,2025,49(12):1559-1565,7.基金项目
浙江省"尖兵领雁+X"研发攻关计划项目(2024C03192) （2024C03192）
国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目(GZY-ZJ-KJ-24011) "Pioneer"and"Leading Goose"R&D Program of Zhejiang Province(2024C03192) （GZY-ZJ-KJ-24011）
Science and Technology Department of State Administration of Traditional Chinese Medicine-Zhejiang Provincial Administration of Traditional Chinese Medicine Co-construction Project(GZY-ZJ-KJ-24011) （GZY-ZJ-KJ-24011）
