从“去菀陈莝”论治产后抑郁症的中医病机及治法

Discussion on TCM Pathogenesis and Treatment of PPD from “Quyuchencuo”

现代医学对产后抑郁症(postpartum depression, PPD)的发病机制仍在探索阶段,各类抗抑郁药物尚存一定缺陷。而传统中医药安全、有效、全面等特点对治疗该病展现出了极大的潜力。基于传统中医经典理论,认为产后抑郁症的病机是气机郁结,在本为肝失疏泄、脾失健运、心失所养等脏腑气血阴阳失调,在标为痰、火、湿、瘀等秽浊菀陈。提出基于“去菀陈莝”理论,辨证施以疏肝解郁、健脾养心、化痰散结、活血化瘀等治法及中药主方、针灸选穴;并强调治疗过程中将“气郁达之”之法一以贯之,配合恰当的心理暗示以移情易性,共奏补虚泻实、身心同调之效。

Modern medicine is still exploring the pathogenesis of postpartum depression (PPD), and there are still some defects in various antidepressants. The safe, effective and comprehensive characteristics of TCM have shown great potential in the treatment of PPD. Based on the classical theory of TCM, the core pathogenesis of PPD is depression of liver-qi, including the imbalance of qi and blood and Yin and Yang, such as liver loss, spleen loss, and heart loss, etc., which are labeled as phlegm, fire, wet, stasis and other filth accumulation. In view of the “Quyuchencuo” theory, according to the specific situation, the treatment methods such as relieving liver and depression, invigorating spleen and nourishing heart, clearing phlegm and dispersing knot, promoting blood circulation and removing blood stasis, as well as the main prescription of TCM and acupuncture. The principle of “making the stagnant qi smooth” is emphasized throughout the whole treatment, with the appropriate psycho-logical suggestion to empathy, to achieve the effect of tonifying deficiency and purging excess, phys-ical and mental harmony.