基于肾与三焦相通理论探讨抑郁病机与治疗

Discussion on Pathogenesis and Treatment of Depression Based on theTheory of Connection Between Kidney and Trifocal Energizer

“脏腑别通”理论中提出少阴肾与少阳三焦气化相通、共主枢机,具有通行元气、司水液代谢的作用;“阴升阳降”理论中提出少阴肾与少阳三焦能够配合调节机体阴阳气机升降。“肾脑相济”以肾精为物质基础,阳气温煦、推动肾和三焦别通气化、共主枢机可作为功能基础,其生理功能可体现在调节三焦气机和调理脑神。肾阳亏虚、三焦气滞均可引发别通气化不利、“阴升阳降”失常,导致“肾脑相济”乏源,可出现本虚标实、神形兼伤病证如抑郁,且可伴随躯体化症状如疼痛、睡眠障碍、食欲不振等。根据肾与三焦气化相通这一功能特性选择调节少阳枢机以补肾阳、调补少阴枢机以利三焦以维持“肾脑相济”,可同时治疗抑郁和躯体化症状。文章探讨了在阳气作用下肾与三焦气化相通在肾与脑神相关的生理联系如“肾脑相济”、相关病证如抑郁的发病机制和治疗中发挥的作用。

According to the theory of“Zang-Fu extra-ordinary connection”,the Qi transformation of the Shaoyin kidney and Shaoyang triple energizer are connected and govern the pivot,which has the function of passing the primordial Qi and governing the metabolism of water and liquid;In the theory of“ascending of Yang and descending of Yin”,it is proposed that Shaoyin kidney and Shaoyang triple energizer can cooperate to regulate the ascending and descending of Yin-Yang Qi.The“harmony between kidney and brain”is based on the material foundation of kidney essence.Yang Qi is warming and promoting kidney and triple energizer to extra-ordinarily connect the Qi transformation and govering the pivot,which can serve as the functional basis.Its physiological function can be reflected in regulating the triple energizer Qi movement and cerebral soul.Deficiency of kidney Yang and stagnation of Qi in the triple energizer can lead to dysfunction of Qi transformation and“ascending of Yang and descending of Yin”,leading to a shortage of“harmony between kidney and brain”.It can lead to diseases such as depression with somatic symptoms such as pain,sleep disorders,and loss of appetite.It is caused by deficiency in origin and excess in superficiality,as well as cerebral soul and body injury.According to the functional characteristics of the connection of the Qi transformation between the kidney and the triple energizer,the pivot of Shaoyang can be adjusted to supplement the kidney Yang,and the pivot of Shaoyin can be adjusted to benefit the triple energizer to maintain the“harmony between kidney and brain”,which can simultaneously treat depression and somatic symptoms.According to this paper discusses the role of the connection of Qi transformation between kidney and triple energizer under the action of Yang in the physiological relationship between kidney and spirit-brain,such as harmony between kidney and brain,and the pathogenesis and treatment of related diseases such as depression.