摘要
临床研究表明卒中后出现抑郁症比无抑郁症的卒中发病率更高,且患者的精神状态较差。随着医疗水平的提升及心身医学的发展,卒中后抑郁(PSD)逐渐受到重视。PSD的病机较为复杂,但总以情志内伤,气机郁结为主,同时肾精不足、肝肾亏虚贯穿本病始终,治疗需在疏肝理气的基础上兼顾补益肝肾,其次再予以辨证论治,临床多将本病分为肝气郁结、肝郁化火、痰气交阻、虚热内扰、心脾两虚、瘀阻脑络等证型。针对其病因病机,常以柴胡配郁金疏肝、清心、解郁;熟地配陈皮补肾益髓,行气健脾;丹皮配栀子清肝泻火除烦;苏梗配半夏行气化痰;柏子仁配酸枣仁养心安神;女贞子配墨旱莲滋补肝肾;白术配太子参补气健脾;龙骨配牡蛎镇惊安神。
Clinical research shows that the incidence rate of stroke with depression after stroke is higher than that without depression,and the mental state of patients is worse.With the improvement of medical level and development of psychosomatic medicine,gradually paid attention to post stroke depression(PSD).The pathogenesis of PSD is relatively complex,but it is always characterized by emotional internal injury,stagnation of qi,and deficiency of kidney essence and liver and kidney throughout the disease.On the basis of soothing the liver and regulating qi,the treatment should give consideration to tonifying the liver and kidney,and then give dialectical treatment.PSD can be clinically divided into several syndrome types,such as stagnation of liver qi,transformation of liver qi into fire,obstruction of phlegm and qi,internal disturbance due to asthenic fever,deficiency of both heart and spleen,and obstruction of brain collaterals due to blood stasis.In view of its etiology and pathogenesis,use bupleurum with aromatic turmeric root-tuber to soothe the liver,clear the heart and relieve depression.Prepared rehmannia root with tangerine peel,tonifying the kidney and marrow,promoting qi and strengthening the spleen.Tree peony bark with fructus gardeniae clearing liver,reducing fire and eliminating annoyance.Perillae caulis with pinellia ternate for promoting qi and resolving phlegm.Cypress kernel with sour jujube kernel to nourish the heart and calm the mind.Ligustrum lucidum with eclipta nourishing liver and kidney.Atractylodes macrocephala combined with radix pseudostellariae can invigorate qi and spleen.Keel with oyster calms nerves.
作者
陈潇
刘红梅
袁惠民
丁砚秋
毛丽军
赵丹
CHEN Xiao;LIU Hongmei;YUAN Huimin;DING Yanqiu;JIN Yongzuo;MAO Lijun;ZHAO Dan(Beijing University of Traditional Chinese Medicine,Beijing 100029,China)
出处
《陕西中医》
CAS
2023年第3期383-386,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄学者)——国家中医药领军人才支持计划项目[国中医药人教发(2018)12号]
中国民族医药学会科研项目(2019KYXM-Z1109-51)。
关键词
卒中后抑郁
药对
疏肝解郁
益气健脾
补肾益髓
行气化痰
Post stroke depression
Drug pair
Shugan Jieyu
Yiqi Jianpi
Bushen Yisui
Xingqi Huatan
