从脾胃论治抑郁症理论探析

Exploration on the Theory of Treating Depression from the Perspective of Spleen and Stomach

抑郁症可归属中医学“郁证”范畴。中医临床治疗抑郁症在常规通用的从肝论治之外,亦不可忽视从脾胃论治抑郁症的思路。脾胃主受纳运化,脾胃为气机升降枢纽,抑郁症病机与脾胃虚弱、脾胃湿困所致的脾失健运,以及与气血亏虚、气滞血瘀所致的气血失调密切相关。脾失健运,气血化生不足,脏腑失养;水液代谢异常,聚湿凝痰;中焦气机升降失调,气滞血瘀,浊邪上扰,虚、痰、瘀、滞相兼,发为抑郁。从脾胃论治抑郁症需以健脾化痰、疏肝理气为要,以使气血充沛,阴阳调和,枢机重建,情志条畅。

Depression can be classified under the category of “depressive syndrome”in the field of traditional Chinese medicine. In addition to the conventional Chinese medicine treatment of depression from the perspective of liver,the clinical treatment of depression from the perspective of spleen and stomach should also be taken into account. The spleen and stomach are primarily responsible for digestion and absorption, and the spleen and stomach are the pivot of the qi movement. The pathogenesis of depression is closely related to the deficiency of spleen and stomach,spleen failing in the transportation due to damp retention in the spleen and stomach,and the disharmony of qi and blood due to deficiency of both qi and blood and qi stagnation and blood stasis. Failure of spleen in the transportation results into the insufficiency of qi and blood and malnutrition of the zang-fu organs,the dysfunction of water metabolism leads to dampness-accumulation and phlegm-coagulation, and the disharmony of qi movement in the middle energizer causes qi stagnation and blood stasis,and upward attack of turbid pathogen. And then the complication of deficiency, phlegm, stasis and stagnation eventually lead to depression. The treatment of depression from the perspective of the spleen and stomach should be based on the principles of invigorating spleen and resolving phlegm,soothing liver and regulating qi,so as to enrich qi and blood,harmonize yin and yang,rebuild the pivot and smooth the emotion.