李振华疏肝健脾、豁痰清心辨治脏躁病经验

Clinical Experience of TCM Master LI Zhen-hua in Treatment of Zangzao Disease: Smoothing Liver-qi,Invigorating The Spleen and Eliminating Phlegm to Clear Heart

李振华教授在研究脏躁病的过程中,认为该病病因缘于精神受到刺激,肝失疏泄条达,郁而化火,肝火过盛则耗伤肾阴,肾水不能正常抑制心火,水火不济,肝火、心火旺盛出现神经失控和思维混乱;肝失疏泄、肝气横逆又可损伤脾胃,水湿运化失常,湿遇火而成痰,痰随肝气上逆蒙蔽清窍则思维更加混乱不能自主,因此肝、脾、心、肾是本病的主要病位,其病机为肝郁脾虚,心肝脾肾四脏功能失调。治疗以"通"字为先,宜疏通肝气,气行则湿行,健脾化痰,清心豁痰,痰湿消失,痰热成无根之火,痰火便自行消散。依照疏肝理气、健脾化痰、清心豁痰安神的治法,李振华教授研制出"清心豁痰汤"治疗脏躁病。

In the study of the process of Zangzao disease,TCM master LI Zhen-hua points out that the Zangzao disease caused by the spirt of stimulaton,which leads to liver dysfunction and Qi depression transforming into fire.Furthermore,it leads to the consumption of kidney Yin and exuberance of heart-fire. Finally,discordance between water and fire occurs. For another,transverse dysfunction of liver qi impairs spleen and stomach,leading to dysfunction of water transforming. Fire transforms dump into phlegm,which confound the orifices of the head along with the reversed flow of qi and increases the confusion. Therefore,the disharmonies caused by Zangzao disease among heart,liver,spleen and kidney,contribute to Zangzao disease development. Because of its complicated pathogenesis,Professor LI prefers to clearing rather than tonifying in depression treatment. To clear means to smooth liver-qi. When Qi flows smoothly,dampness will disappear. To clear also means invigorating the spleen to reduce phlegm and eliminating phlegm to clear heart. Fire will disappear with the phlegm. According to his clinical experience,Professor LI sums up the treatment of depression is relieving liver to smooth Qi,invigorating spleen to reduce phlegm and eliminating phlegm to clear heart. Based on this,he creates Qingxinhuotan decoction for the treatment of Zangzao disease.