基于“开阖枢”理论探讨卒中后抑郁的针刺治疗思路

Exploration of Thoughts for Treatment of Post-stroke Depression with Acupuncture Therapy Based on Theory of Opening,Closing,and Pivoting Function of Meridians

开阖枢理论是《黄帝内经》中的重要内容之一,指的是太阴太阳为开、少阴少阳为枢、厥阴阳明为阖,阐释了气机流转的整个过程。卒中后抑郁多是由于气机升降失常所致。基于此理论阐释三阴三阳开阖枢与卒中后抑郁病因病机的内在联系,可指导针刺治疗卒中后抑郁的理气开郁为先,调节经气、调和脏腑阴阳治疗原则的确立,指导经脉与穴位的选取,为临床针刺治疗卒中后抑郁的取穴思路的开拓及治疗方案的优化提供一定的参考。

The theory of opening,closing,and pivoting function of the meridians is one of the important contents recorded in Huangdi’s Canon of Medicine, referring to the function of the meridians in regulating the qi movement,i.e.,Taiyin and Taiyang meridians being in charge of the opening function of qi movement,Shaoyin and Shaoyang meridians being in charge of the pivoting function of qi movement, and Jueyin and Yangming meridians being in charge of the closing function of qi movement. Post-stroke depression is mostly caused by dysfunction of qi movement. Based on the theory of the opening,closing,and pivoting function of the meridians,we explored the inner link of opening,closing,and pivoting function of the three yin meridians and three yang meridians with the etiology and pathogenesis of post-stroke depression. The results indicated that the theory of the opening, closing, and pivoting function of the meridians is helpful for the establishment of the therapeutic principles of regulating qi for the relief of depression firstly by regulating meridian qi,and then regulating zang and fu organs and yin and yang,and can supply reference for the selection of meridians and acupoints. The discussion will provide evidence for the exploration of the thoughts for the acupoints selection and for the optimization of therapeutic regimen for the treatment of post-stroke depression with acupuncture therapy.