强宝全针刺治疗更年期抑郁症经验

QIANG Bao-quan's Experience of Treating Menopause Depression with Acupuncture

更年期抑郁症病因主要在心神,病本在肾,与肝相关,强教授认为治疗本病应"木郁达之",以疏通气机为要,同时需要明辨虚实阴阳,以达到阴阳和合、气机调畅,神有所养,同时还要顾护脾胃,注重心理疏导。取穴以督脉、手足厥阴经腧穴为主,多针刺百会、四神聪、内关、神门、大陵、膻中、太冲、中脘、足三里等穴。临床根据病情不同,辨证用药,随症加减。1肝气郁结证:治以调神疏肝,理气和中,针刺加行间、支沟。2心肝火郁证:治以疏肝解郁,清泻肝火,针刺加行间、内庭、支沟。3痰气郁结证:治以行气疏肝,化痰散结,针刺加天突、丰隆、照海。4心脾两虚证:治以健脾养心,调神安智,针刺加脾腧、通里。5心肾阴虚证:治以滋养心肾,针刺加太溪。另外,咽部异物硬塞感明显者加照海、天突;癔症性失明者加睛明、四白、光明;癔症性失听者加耳门、听宫、听会;癔症性失语症加廉泉、旁廉泉。

The etiology of menopause depression focuses on the mind, the disease root is in the kidney, and the liver is involved. Professor Qiang thinks that stagnation of wood should be treated by relieving therapy in order to unblock qi activity, exactly identi- fy asthenia,sthenia,yin and yang, reach harmony of yin and yang, regulate qi activity, nourish the mind. At the same time, the spleen and stomach should also be protected,and physical counseling should be paid attention to. The choice of points should fo- cus on governing vessel, and hand-foot jueyin meridian, such as Baihui （ GV 20）, Sisheneong （ Ex-HN 1 ） , Neignan （ PC 6）, Shenmen （ M A ） , Daling （ PC 7 ） , Tanzhong （ CV 17 ） ,Taichong （ LR 3 ） , Zhongwan （ CV 12 ） , Zusanli （ ST 36 ）. In the clinical practice, according to exact disease condition, treatment and drug use should be based on syndrome differentiation. For syndrome of liver-qi stagnation, Xingjian （ LR 2 ） and Zhigou （TE 6） are added to regulate the mind and disperse stagnation. For syndrome of stagnation of the heart and liver fire, Xingjian （ LR 2 ） , Neiting （ ST 44） and Zhigou （ TE 6 ） are added to disperse the liver and remove stagnation. For syndrome of phlegmatic stagnation,Tiantu （ CV 22 ） , Fenglong （ ST 40） and Zhaohai （ K1 6） are added to move qi and disperse the liver,resolve phlegm and remove stagnation. For syndrome of deficiency of both the heart and spleen, Pishu （BL 20） anti Tongli （HT 5） are added to strengthen the spleen,nourish the heart and regulate the mind. For syndrome of heart and kidney-yin deficiency ,Taixi （KI 3 ） is added to nourish the heart and kidney. What＇s more ,for obvious sense of foreign body in pharynx shoehorn, Zhaohai （ KI 6 ） and Tiantu （ CV 22） are added. For hysterical blindness, Jingming （ BL 1 ） , Sibai （ST 2） and Guangming （GB 37 ） are added. For Hysteria loss of hearing, Ermen （TE 21 ）, Tinggong （SI 19 ） and Tinghui （ GB 2 ） are added. For hysteria in aphasia, Lianquan （ CV 23 ） and Panglianquan （ RN 23 ） are added.