庞玉琴辨治产后抑郁经验

Pang Yu-qin's Experience of Diagnosis and Treatment of Postpartum Depression

庞玉琴教授认为,气血失调、脏腑失和为产后抑郁主要病机,主要涉病脏腑为心、肝、脾,在治疗产后抑郁时,以移情易性,畅气通滞,养血安神为治疗总则。庞教授治疗产后抑郁,调气血与和脏腑并举,移情志与安神魂并重,不忘多虚多瘀之机,辨证分型且分段论治,以气血为路,脏腑为靶,畅气养血,调志安神。肝气郁结者,方用自拟疏郁清明汤;心脾两虚者,方用自拟补益定神汤。庞教授治疗产后抑郁强调当分阶段施治:若妇女新产阶段发生产后抑郁,以活血祛瘀为主,加川芎、桃仁、炮姜之品;若妇女产后子宫已恢复,以补益气血为要,加当归、丹参、黄芪之品。另外,产后用药需要注意:产后不宜单用过用补益之品;产后不宜单用破血之品;产后不能过用寒凉;产后不能过用辛散之品。

Professor Pang Yu-qin believes that the main pathogenesis of postpartum depression is the imbalance of qi and blood,as well as the disharmony of the organs involved.The main organs involved are the heart,liver,and spleen.When treating postpartum depression,the general principles of treatment are transfering emotions,promoting qi circulation,dredging stagnation,and nourishing blood and stablizing the mind.When treating postpartum depression,Professor Pang emphasizes both regulating qi and blood and coordinating the internal organs,placing equal emphasis on transfering emotions and and stablizing the mind,without ignoring the mechanisms of multiple deficiencies and blood stasis,so she adopts distinguishing syndrome types and treating them in stages.She takes qi and blood as the path and the internal organs as the targets to treat postpartum depression.For those with liver qi stagnation,she uses self-made Decoction for Soothing Stagnation and Clearing the Heart.For those with heart-spleen deficiency syndrome,she adopts self-made Decoction for Boosting Qi and Stablizing the Mind.Professor Pang emphasizes the phased treatment of postpartum depression:if a woman experiences postpartum depression in the stage immediately after giving birth,the main treatment should be to promote blood circulation and remove blood stasis,and the products of Chuanxiong(Rhizoma Chuanxiong),Taoren(Semen Persicae),and Paojiang(Rhizoma Zingiberis Praeparatum)are often added;If the uterus of a woman has recovered after childbirth,tonifying qi and blood is essential,and products such as Danggui(Radix Angelicae Sinensis),Danshen(Radix Salviae Miltiorrhizae)and Huangqi(Radix Scutellariae)can be added.In addition,postpartum medication should be noted that after childbirth,it is not advisable to solely use tonifying products as well as blood-breaking products.The products that are ex cessively cold or pungent can not be used either.