摘要
“一气周流”理论源于清代御医黄元御,历史悠久,内涵丰富。围绝经期失眠伴焦虑抑郁状态是临床上一种常见的生理-心理疾病,属于中医郁证的范畴,严重影响患者的日常生活,给临床治疗带来极大挑战。长期反复失眠可加重焦虑抑郁状态,而焦虑抑郁状态亦加重失眠,互为因果,形成病郁同存的疾病状态。结合围绝经期女性的生理特点,认为气郁为发病的关键因素且贯穿疾病全过程,其病机演变分为气郁为先,急性起病;气郁生痰,病理过渡;气郁生瘀,慢性迁延三个阶段,其本质与气滞、痰浊、瘀血等病理因素密不可分且递进发展,日久形成恶性循环圆运动。根据演变的不同阶段及现代临床表现,探索性提出气郁同治、痰郁同治、瘀郁同治的诊疗思路,从而实现心神同治、身心同治,为临床诊疗提供参考。
The theory of“one Qi peripheral flow”originated from HUANG Yuanwu,an imperial physician of the Qing Dynasty,with a long history and rich connotation.Perimenopausal insomnia with anxiety and depression is a common physiological-psychological disease in clinical practice,which belongs to the category of depression in traditional Chinese medicine,seriously affecting patients'daily life and posing a great challenge to clinical treatment.Repeated insomnia over a long period of time can aggravate the state of anxiety and depression,and the state of anxiety and depression also aggravates insomnia,which is the cause and effect of each other,forming a state of disease and depression coexisting together.Combined with the physiological characteristics of perimenopausal women,it is believed that Qi depression is the key factor in the pathogenesis of the disease and runs through the whole process of the disease,and the evolution of its pathology is divided into three stages:Qi depression is the first stage,with acute onset;Qi depression generates phlegm,with pathological transition;and Qi depression generates blood stasis,with chronic prolongation,the essence of which is closely related to the pathologic factors of Qi stagnation,phlegm,blood stasis,and other factors with progressive development,which forms the malignant cycle of circular movement in a long period of time.According to the different stages of evolution and modern clinical manifestations,the diagnostic and therapeutic ideas of Qi stagnation and stagnation,phlegm stagnation and stagnation and stagnation of blood are explored and put forward,thus realizing the treatment of mind and spirit,body and mind,and providing references to the clinical diagnosis and treatment.
作者
吕少辉
陈昺伃
王彦华
赵敏
LYU Shaohui;CHEN Bingyu;WANG Yanhua;ZHAO Min(Henan University of Traditional Chinese Medicine,Zhengzhou 450046,Henan,China;Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,Henan,China)
出处
《辽宁中医药大学学报》
CAS
2024年第8期57-61,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
“十四五”国家重点研发计划“中医药现代化研究”重点专项(2022YFC3501103)
河南省自然科学基金项目(222300420227)
河南省科技攻关计划项目(212102311124)
河南省中医药科学研究专项课题(20-21ZY2043,2023ZY2041)。
关键词
一气周流
围绝经期失眠
焦虑抑郁
黄元御
气郁
one Qi peripheral flow
perimenopausal insomnia
anxiety and depression
HUANG Yuan-yu
Qi depression
