从肝郁肺虚论治心脏神经官能症的理论探讨

Theoretical discussion on treating cardiac neurosis from liver depression and lung deficiency

目前大多数中医学者对心脏神经官能症的发病与治疗多从心、肝、脾、肾出发,较少论及肺。从心肝肺影响气血运行的角度,以阴阳、五行、精气血、津液神及经络学说为工具,通过论述肝与肺的功能及生理病理特性,即“肺藏魄”“肺在声为哭”“在志为悲”“肝主疏泄”“肝为五脏之贼”,生理上,心肝相生为母子,行血与藏血互用;心肺互制同居上焦,气血互用;肝肺互制,龙虎回环调畅气机。病理上,肝在五行属木,木易郁而心火塞,从而乘肺金致肺气虚。同时结合现代研究,提出心脏神经官能症起于肝郁,而肝郁肺虚是心脏神经官能症的病机演变结局之一的观点,并提出论治心脏神经官能症当需辨证论治,对于肝郁肺虚证的患者可疏其肝郁、补其肺气。

At present,most Chinesemedicine practitioners treat cardiac neurosis(CN)fromthe heart,liver,spleen and kidney,rarely discuss the lung.And this article uses the hexagrams and the theory of the five elements as tools,from the perspective of the heart,liver and lung’s movement of qi and blood and discusses the functions and physiological and pathological characteristics of the liver and lungs,namely,“lung holds the soul”“lung is crying”and“lung is determined to be sad”“liver governs dispersal”“liver is the thief of the five internal organs”.Physiologically,the heart and the liver are born as mother and child,the blood circulation and storage are mutually used;the heart and lungs interact with each other in shangjiao and the qi and blood are mutually used.Liver and lungs interact with each other system,the dragon and tiger loop to adjust the air machine.Pathologically,the liver belongs to the wood in the five elements and the wood is easy to be stagnant and the heart is blocked by fire,which leads to lung qi deficiency by taking advantage of the lung gold.Furthermore,it is proposed that CN originates from stagnation of the liver and liver stagnation and lung deficiency is one of the outcome of the pathogenesis of CN.It is also proposed that the treatment of CN should be based on syndrome differentiation.For patients with liver stagnation and lung deficiency,lung qi can be supplemented and liver can be soothed and gloomy.At the same time,it discusses its specific treatment methods based on the theory of luck and depression,the experience of ancient physicians and modern classic cases,in order to provide a new perspective and reference for the clinical treatment of CN.