丁元庆运用调气通脉法治疗中青年中风后抑郁症经验

DING Yuanqing's Experience in Treating Young and Middle-Aged Post-Stroke Depression Patients with Regulating Qi and Promoting Blood Circulation Method

总结丁元庆教授运用调气通脉法治疗中青年中风后抑郁症(PSD)的临证经验。PSD是在中风血脉损伤、脑髓神机受累基础上因病致郁的病证,提出卫阳变动、气机逆乱、血脉病损是其发病关键。中青年中风后不良生活方式、原有慢性疾病控制不当及睡眠障碍等各种因素既可单独为害,又可相互叠加作用,导致卫阳困遏、气机逆乱、血脉不利,卫阳郁滞日久,致生风化火,灼津为痰,炼血为瘀,郁热与痰瘀相互胶结,可进一步损伤脉道,则卫伐营涩,脑髓失养,神机不用,形成抑郁症。临床应用调气通脉法,通过疏气清气益气、和血通脉宣络、开郁振颓怡神达到治疗PSD目的,选取桂枝汤、保元汤等经典方剂及二丹汤、二竹方等自拟方加减治疗。

This paper summarizes the experience of professor DING Yuanqing in treating post-stroke depression(PSD)of young and middle-aged patients with the method of regulating qi and promoting blood circulation.PSD is a syndrome resulting by vascular injury and impairment of brain marrow and vital activity after the stroke.Factors such as poor lifestyle,improper control of chronic diseases and sleep disorders,etc.,which can be harmful individually,or they can interact.Over time,these factors can block yang of defensive qi,obstract blood circulationg and disturb qi movement.Reverse ascending of defensive qi can generate wind and fire,generate phlegm and stasis from the fluid the blood.Qi stagnation,phlegm and stasis can combined with stagnation heat,phlegm heat,blood stasis heat which caused by stroke,which can further aggravate pulse accumulation,damage the blood vessels and block the collaterals.Consequently,defensive qi is floating over and nutrient qi is not smooth,resulting in inadequate nourishment of the brain marrow,and disfunction of vital activity,causing depressive symptoms.Professor DING innovatively applied the method of regulating qi and promoting blood circulation.He selected the classic prescriptions such as Guizhi Decoction(桂枝汤),Baoyuan Decoction(保元汤),as well as self-fitting prescriptions like Erdan Decoction(二丹汤),Erzhu Decoction(二竹汤),to relieve qi and tonify qi,promote harmonious blood circulation,facilitate vasodilation,ease symptoms of depression,invigorate the mind,and provide an effective treatment for PSD.