顾健霞自拟天麻合欢枣仁汤治疗高血压病合并焦虑抑郁经验

GU Jianxia’s experience in treating hypertension complicated with anxiety and depression with the Tianma Hehuan Zaoren decoction

高血压病患者常出现焦虑、抑郁情绪,而焦虑、抑郁情绪与血压常相互影响,导致临床治疗效果不佳,中西医结合治疗两者合病具有明显优势,可有效改善患者症状,并提高临床疗效。顾健霞主任医师从事中医药防治心血管疾病多年,临床经验丰富,认为高血压病合并焦虑、抑郁多与年老体虚、情志内伤有关。年老者多肝水不足、肝阴虚耗,无以制阳,以致肝阳上亢。加之肝气不舒,扰心乘脾,血气失和,诸邪内生,风、火、痰、瘀相互交阻,病机虚实错杂。追本溯源,阴虚肝郁为发病之本,心主不明、脾虚失健亦在疾病的发生中起到重要原因。病位在于肝、心、脾,治疗上采用平肝疏肝、养心安神、健脾扶土之法,三脏同调,自拟天麻合欢枣仁汤治疗本病,随证加减,可有效改善患者焦虑抑郁症状及睡眠情况,并取得较好临床疗效。文章结合案例介绍顾健霞自拟天麻合欢枣仁汤治疗高血压病合并焦虑抑郁经验,以期为相关临床治疗提供参考。

Patients with hypertension often have anxiety and depression,the two often interact,leading to poor clinical treatment effect.The combination of the integrated medicine has obvious advantages in the treatment of combined diseases,which can effectively improve the symptoms of patients and the clinical efficacy.GU Jianxia has been engaged in the prevention and treatment of cardiovascular diseases with TCM medicine for many years and has rich clinical experience.Elderly people lack of liver water,liver Yin(阴)deficiency,unable to control Yang(阳),resulting in hyperactivity of liver Yang.Liver Qi(气)is not comfortable,disturbing the heart and spleen,disharmony of courage and uprightness,excessing of pathogenic Qi.Wind,fire,phlegm and blood stasis block each other,and the pathogenesis is mixed with deficiency and excess.Tracing back to the origin,Yin deficiency and liver depression is the root cause of the disease,and heart anti-controlling mind and spleen deficiency also play an important role in the occurrence of the disease.The location of the disease lies in the liver,heart and spleen.In the treatment,the method of leveling the liver and nourishing the liver,nourishing the mind and calming the mind,strengthening the spleen and helping the earth is adopted,and the three organs are in the same tune.The self-designed Tianma Hehuan Zaoren decoction(天麻合欢枣仁汤)is used to treat the disease,which can effectively improve the symptoms of anxiety and depression and sleep of patients with the syndrome.This paper combines cases to introduce chief physician GU Jianxia’s experience in the treatment of hypertension with anxiety and depression,in order to provide clinical reference.