从肺论治郁证经验探析

Experience of Treating Depression Syndrome from Lung

凡郁病必先气病,肺作为气之大主,诸气愤郁皆属于肺,故治郁先理肺,肺气畅达则一身之气畅达,郁证自除。翻阅典籍、文献,从古至今从肺论治郁证的理论探讨并不鲜见,但秉持从肺论治郁证原则,针对不同辨证阶段归纳出行之有效的治则治法及方剂者寥寥无几。本文从肝与肺的关系、肺的生理功能出发论证了肺郁的病因病机及从肺论治郁证的必要性,并总结导师王兴臣教授从肺论治郁证的辨证论治经验,根据患者寒热虚实及病情所处阶段辨证论治,肺气素虚、气机宣降失常者,治宜补肺汤加减;肺气郁闭、瘀热阻滞者,治宜上焦宣痹汤合麻黄连翘赤小豆汤加减;气郁日久、肺气阴耗伤者,治宜百合固金汤加减,分阶段论治郁证,以期为郁证的临床辨证与治疗提供借鉴与参考。

All depression diseases must be preceded by Qi diseases.The lung is the main body of Qi,and all kinds of Qi,anger and depression belong to the lung.Looking through ancient books and literatures,it is not uncommon to explore the theory of treating depression from the lung,but few people adhere to the principle of treating depression from the lung,and summarize the effective treatment principles,methods and prescriptions for different stages of syndrome differentiation.Based on the relationship between liver and lung and the physiological function of lung,this paper demonstrates the etiology and pathogenesis of lung depression and the necessity of treating depression syndrome from lung,and summarizes Professor WANG Xing-chen’s experience in treating depression syndrome from lung.According to the syndrome differentiation of patients with deficiency and excess of cold and heat and the stage of illness,the treatment of deficiency of lung Qi element and disorder of Qi circulation should be modified by Bufei decoction;For those with stagnation of lung Qi and stagnation of blood stasis and heat,Shangjiao Xuanbi Decoction and Mahuang Lianqiao Chixiaodou Decoction should be modified in order to provide reference for clinical syndrome differentiation and treatment of depression syndrome.