山西中医药大学学报2026，Vol.27Issue(8)：928-935,8.DOI:10.19763/j.cnki.2096-7403.2026.05.28
基于《黄帝内经》经别理论探讨卒中后抑郁肺脑同病机理及从肺干预思路
Pathogenesis of pulmonary-brain comorbidity in post-stroke depression based on the divergent meridian theory in Huangdi Neijing and insights into lung-centered intervention
摘要
Abstract
Post-stroke depression(PSD),one of the most common complications following stroke,not only significantly diminishes patients ' quality of life but also delays neurological recovery,increases disability and recurrence rates,and ex-erts profoundly negative effects on prognosis.Traditional Chinese Medicine(TCM),with its holistic perspective and individu-alized treatment based on syndrome differentiation,has accumulated substantial clinical experience in the management of PSD,providing important support for symptom alleviation and therapeutic improvement.However,current TCM syndrome differentiation systems for PSD generally overlook the pivotal role of the lung in the onset and progression of the disease,thereby limiting therapeutic approaches.In light of this,the present study takes the divergent meridian theory from Huangdi Neijing(The Yellow Emperor's Inner Classic)as its core theoretical foundation,delving into the connecting and communicat-ing functions of the meridian system to establish a core pathophysiological channel linking the lung and the brain through meridian connections and qi-blood interplay within the TCM framework,thereby clarifying the theoretical basis for pulmonary-brain comorbidity.Concurrently,by integrating modern biomedical evidence on the biological characteristics of pulmonary-brain comorbidity in PSD patients—such as the association between pulmonary dysfunction and cerebral neu-rotransmitter disturbances—along with TCM principles including"the lung governs qi and manages respiration"and"the lung connects with all blood vessels",this study systematically proposes a dynamic pathological transformation process for PSD:"lung qi depression and sweat pore closure→lung qi deficiency and loss of nourishment for the brain spirit→metal fail-ing to generate water and insufficiency of brain marrow".This elucidates the evolutionary pattern of the disease from its early to late stages.Regarding therapeutic strategies,this study innovatively proposes a three-stage treatment approach for PSD:the early stage focuses on diffusing the lung and opening the orifices to regulate qi movement;the middle stage emphasizes tonifying lung qi to nourish the brain spirit;and the late stage stresses enriching the lung to generate water for replenishing brain marrow,thereby formulating a targeted,stage-specific treatment protocol.This study aims to address the current inad-equacy in addressing lung function within TCM syndrome differentiation and treatment for PSD,providing a novel theoretical basis and practical direction for the prevention and treatment of PSD with TCM,thereby broadening clinical therapeutic per-spectives and enhancing overall efficacy.关键词
卒中后抑郁/肺/脑/经别/辨证论治Key words
post-stroke depression/lung/brain/divergent meridian/syndrome differentiation and treatment分类
医药卫生引用本文复制引用
张晨辉,李亚丽,赵波,司路佳,倪海波,李蕾..基于《黄帝内经》经别理论探讨卒中后抑郁肺脑同病机理及从肺干预思路[J].山西中医药大学学报,2026,27(8):928-935,8.基金项目
山西省科技创新人才团队建设项目(202204051002011) （202204051002011）
山西省中医药管理局项目(2023ZYYB018,2022ZYYC042) （2023ZYYB018,2022ZYYC042）
山西省吕景山针药对法传承技术创新中心项目 （）
