司国民运用越鞠丸合百合知母汤治疗郁证经验

SI Guomin’s Experience in Treating Depression Syndrome with Yueju Pill(越鞠丸)and Baihe Zhimu Decoction(百合知母汤)

郁证为临床常见病证,多由情志不遂引发,其发病率高、病程长、易反复发作、临床治愈率偏低。司国民教授认为郁证的发生多与社会压力及现代人起居无常、饮食无节、劳逸失度、思虑过度等亚健康状态有关。研究取法仲景思想,并结合朱丹溪“阳常有余,阴常不足”的理论指导,认为郁证发病主要涉及气分,日久深入血分,总体病机为气滞肝郁、郁久化火伤阴之证,并提出治疗郁证应以疏肝理气为主,同时注重固护患者阴液,以防燥湿芳香之药耗伤人体津液。司教授临床实践以越鞠丸与百合知母汤合方为基础方,以香附、栀子、百合、知母等为主药,以疏肝解郁、清热滋阴为治则,并根据患者病情辨证施治。现将临床治疗该病的辨证思路与用方特点介绍如下,并介绍临床运用该合方案例2则,以期为中医临床工作者提供相应的诊治思路。

Depression is a common clinical disease,which is caused by emotional failure.Its incidence rate is high,the course of disease is long,and it is easy to relapse.Professor SI Guomin thinks that the occurrence of depression syndrome is mostly related to social pressure and the sub-health state of modern people,such as impermanence of daily life,disordered diet,loss of work and leisure,and excessive thinking.Professor SI took Zhongjing’s thought and combined with ZHU Danxi’s theory of“Yang is often more than Yin,but Yin is often less than Yang”.He thought that the pathogenesis of depression mainly involves Qi and blood,and the overall pathogenesis is Qi stagnation and liver depression,which turns fire into Yin.He also proposed that soothing the liver and regulating Qi should be the main treatment for depression,and at the same time,attention should be paid to protecting the Yin fluid of patients,so as to prevent the body fluid from being damaged by the dry and wet fragrant drugs.Professor Si often takes Yueju Pill(越鞠丸)and Baihe Zhimu Decoction(百合知母汤)as the basic prescription in clinical practice,with Xiangfu(Cyperi Rhizoma),Zhizi(Gardeniae Fructus),Baihe(Lilii Bulbus)and Zhimu(Anemarrhenae Rhizoma)as the main drugs,and takes soothing liver and relieving depression,clearing heat and nourishing Yin as the treatment principle,and treats according to the patients’condition.Now professor SI’s clinical treatment of the disease and the characteristics of the prescription are introduced as follows,and two cases of clinical application of the combined prescription are introduced,in order to provide the corresponding diagnosis and treatment ideas for the clinical workers of traditional Chinese medicine.