基于心藏神理论探索冠心病合并焦虑抑郁的证治

Pattern differentiation and treatment of coronary heart disease with anxiety and depression based on theory of “heart housing shen”

心藏神理论在《黄帝内经》中已臻于成熟,在现在的临床实践中仍具有重要指导意义。冠心病合并焦虑抑郁、失眠等精神心理障碍称为“双心疾病”。通过阐释心藏神的理论内涵,以及心藏神与冠心病合并焦虑抑郁的内在联系,认识到心不藏神是冠心病合并焦虑抑郁的关键因素,“双心同治”“形神共调”是其基本治疗原则。又因此病的发生与心脏、肝脏关系密切,故又当辅以养心安神、活血化瘀,或调理气机、疏肝解郁。

The theory of “heart housing shen(mind)” elaborated on in Huangdi Neijing(Huangdi’s Internal Classic) has important guiding significance in clinical practice. In view of the prevalence and morbidity of coronary heart disease with anxiety and depression, which is considered to be the disorder of heart’s function, the heart failing to house shen could be used in explanation of its pathogenesis. This paper explains the theoretical connotation of “heart housing shen” and the intrinsic connection between such a theory and the coronary heart disease with anxiety and depression. Based on that, it is stated that “treatment to restore the heart’s dual functions” and “simultaneous treatment of the body and mind” are the fundamental treatment principles for that disorder. Besides, as the onset of the coronary heart disease with anxiety and depression is also closely related to the liver, both the heart and liver should be addressed by nourishing the heart and calming the shen, promoting blood circulation and removing blood stasis, and regulating the liver qi to relieve qi stagnation.