基于“六郁”理论探讨心脏神经症发病和治疗

Discussion on the Pathogenesis and Treatment of Cardiac Neurosis Based on the Theory of“Six Depression”

探讨从“六郁”理论论治心脏神经症的临床意义,为中医药在心脏神经症领域的辨证施治建立新的理论体系。心脏神经症是内科常见的功能性神经症之一,西方现代医学疗效欠佳,且存在不良反应大、价格昂贵等弊端。该文以丹溪“六郁”理论为基础,分别从气郁、血郁、痰湿、火郁、食郁方面阐述心脏神经症发展演变的病因、病机及治法方药等,在“六郁”理论与心脏神经症病因病机的相关性方面强调“六郁以气郁为先”“六郁相因为病”“凡郁皆在中焦”等,治疗上以疏肝理气、行气解郁为基本治疗原则,兼施诸郁,顾护脾胃,行活血化痰、祛湿化痰、清热养阴、消食健脾之法。在郁证的后期应注意随证加用清热、生津、实脾、补气之品等,以期为中医药防治心脏神经症提供新的理论参考。

To explore the clinical significance of treating cardiac neurosis from the theory of“six depression”,and to establish a new theoretical system for the treatment of cardiac neurosis based on syndrome differentiation of traditional Chinese medicine.Cardiac neurosis is one of the common functional neurosis in internal medicine.Western modern medicine has poor curative effect,and has many disadvantages such as large side effects and high prices.Based on Danxi's theory of“six depression”,this article elaborates the etiology,pathogenesis,and treatment of cardiac neurosis from the aspects of Qi stagnation,blood stagnation,phlegm dampness,fire stagnation,and food stagnation.In terms of the correlation between the theory of“six depression”and the etiology and pathogenesis of cardiac neurosis,it emphasizes that“six stagnancies take Qi stagnation as the first”“six stagnancies are caused by diseases”and“all stagnancies are in the middle energizer”.In terms of treatment,it takes soothing the liver,regulating Qi,and promoting Qi to resolve depression as the basic treatment principle,simultaneously applying various types of depression,taking care of the spleen and stomach,promoting blood circulation and resolving phlegm,dispelling dampness and resolving phlegm,clearing heat and nourishing Yin,and promoting digestion and spleen strengthening.In the later stage of depression syndrome,attention should be paid to the use of heat clearing,fluid production,spleen strengthening,and Qi tonifying drugs along with the symptoms,so as to provide new theoretical reference for the prevention and treatment of cardiac neurosis by traditional Chinese medicine.