国医大师韩明向辨治气郁化火型郁证经验

TCM master Han Mingxiang′s experience in differentiating and treating depression syndrome caused by Qi-depression transforming into fire

郁证之气郁化火证是中医学常见证候之一,多表现为胸闷痞塞、烦躁易怒、口干口苦、头晕失眠等,主要见于西医学神经衰弱、癔症及焦虑症等。韩明向教授作为全国第四届国医大师,对郁证的治疗有着丰富的经验,尤其擅长运用“气郁化火”理论辨证论治。韩老认为“气郁化火”证是由内因和外因共同作用而成,因此不仅要“治病求于本”,还应根据外因进行个体化治疗。对于气郁化火型郁证的辨证用药,韩老从气、火、肝三个方面,以“行气解郁,疏肝泻火”为治疗准则,使用“丹栀逍遥散”为基本方,形成肝脾同调,甘苦并用,兼顾扶正的治疗特色。结合临证医案,阐述名中医韩明向教授的学术思想和临床经验,为指导临床实践提供帮助。

Depression syndrome caused by Qi-depression transforming into fire is one of the common syndromes of traditional Chinese medicine,mostly manifested as chest congestion,irritability,dry and bitter mouth,dizziness and insomnia,mainly seen in neurasthenia,hysteria and anxiety disorders in western medicine.As the fourth TCM master,Professor Han Mingxiang has rich experience in the treatment of depression syndrome,especially good at using the theory of“Qidepression transforming into fire”for syndrome differentiation and treatment.Prof.Han believes that the syndrome of“Qidepression transforming into fire”is caused by the joint action of internal and external causes,so it is not only necessary to“seek the root causes for the treatment of the disease”,but also to carry out individual treatment according to external causes.For the medication of depression syndrome caused by Qi-depression transforming into fire based on the syndrome differentiation,Prof.Han takes“promoting Qi to relieve depression,soothing liver and reducing fire”as the treatment principle,and uses Danzhi Xiaoyao Powder as the basic formula according to the three aspects of Qi,fire and liver,forming the therapeutic characteristics of both regulation of liver and spleen,combination of sweet and bitter flavor,and strengthening the body resistance.This paper expounds the academic thought and clinical experience of Prof.Han Mingxiang based on clinical medical cases,a famous TCM doctor,in order to provide help for guiding clinical practice.