1.河南中医药大学,河南省郑州市金水区金水东路156号,450018
2.北京中医药大学国家中医体质与治未病研究院
3.中国中医科学院中医基础理论研究所
4.浙江中医药大学
wangqi710@126.com
收稿:2023-04-05,
修回:2023-06-03,
纸质出版:2023-10-17
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王雪可,李天星,方旖旎等.气郁体质相关病证及方药探析[J].中医杂志,2023,64(20):2057-2062.
WANG Xueke,LI Tianxing,FANG Yini,et al.Exploration of Syndromes and Prescriptions Related to Qi-Depression Constitution[J].Journal of Traditional Chinese Medicine,2023,64(20):2057-2062.
王雪可,李天星,方旖旎等.气郁体质相关病证及方药探析[J].中医杂志,2023,64(20):2057-2062. DOI: 10.13288/j.11-2166/r.2023.20.002.
WANG Xueke,LI Tianxing,FANG Yini,et al.Exploration of Syndromes and Prescriptions Related to Qi-Depression Constitution[J].Journal of Traditional Chinese Medicine,2023,64(20):2057-2062. DOI: 10.13288/j.11-2166/r.2023.20.002.
以气郁体质为切入点,系统梳理总结气郁体质具体病证证候表现及治疗用药。认为气郁体质人群平衡状态失调时可继发一系列病证,归纳总结出了临床最常见的四种病证,即肝郁、虚郁、痰热郁、郁结。“肝郁”为肝失疏泄,气机郁结,治疗主张肝气郁结、脾虚血少用逍遥散;肝郁脾虚、郁而化火用丹栀逍遥散;肝郁化火、气逆上冲用奔豚汤。“虚郁”为长期情志不畅,久则暗耗气血,气血衰少,治疗主张心脾两虚、心神失养用甘麦大枣汤;心肺阴虚、神魄失守用百合地黄汤。“痰热郁”为气机不舒,影响精血津液运行,聚湿成痰化热,治疗主张肝郁不舒、痰凝气结用半夏厚朴汤;肝郁痰热内扰、胆胃不和用柴胡(芩)温胆汤;肝气郁结、痰火内扰用自拟舒肝解郁汤。“郁结”为气滞血瘀痰浊集聚,日久成瘀,治疗主张肝郁不舒、痰火湿食血郁用越鞠丸;肝郁气滞血瘀用自拟乳癖散结汤。
Based on qi-depression constitution, we systematically sorted out and summarized the manifestations of specific symptoms and prescriptions of
qi
-depression constitution. It is believed that a series of syndromes can be developed due to the imbalance in patients with
qi
-depression constitution. The four most common syndromes inclinic were summarized as liver depression, deficient depression, phlegm-heat depression, and stagnation. “Liver depression” resulted from liver failing to free flow of
qi
, then
qi
stagnated, so
Xiaoyao Powder
(逍遥散) was recommended as treatment for liver
qi
depression, spleen deficiency and blood insufficiency;
Danzhi Xiaoyao Powder
(丹栀逍遥散) for liver depression and spleen deficiency, depression transforming into fire;
Bentun Decoction
(奔豚汤) for liver depression transforming into fire, upward rushing of
qi
counterflow. “Deficient depression” resulted from long-term mental disorder and will consume
qi
and blood potentially to
qi
and blood deficiency, so
Ganmai Dazao Decoction
(甘麦大枣汤) was recommended as treatment for deficiency of both heart and spleen, and heart and spleen failing to tonify;
Baihe Dihuang Decocotion
(百合地黄汤) for heart and lung with
yin
deficiency, spirit and soul failing to guard. “Phlegm-heat depression” resulted from disturbance of
qi
movement, affecting the transportation of essence, blood and body fluids, gathering dampness and forming phlegm into heat.
Banxia Houpo Decoction
(半夏厚朴汤) was recommended as treatment for liver depression and failing to transportation, phlegm coagulation and
qi
stagnation;
Chaihu (or Chaiqin) Wendan Decoction
(柴胡(芩)温胆汤) for liver depression and phlegm-heat harassing internally, and disharmony of gallbladder and stomach; self-made
Shugan Jieyu Decoction
(舒肝解郁汤) for liver-
qi
stagnation and phlegm-fire harassing internally. “Stagnation” resulted from stagnation of
Qi
and blood, accumulation of turbid phlegm, and forming stasis over time, so
Yueju Pill
(越鞠丸) was recommended as treatment for liver depression and failing to transportation, phlegm-fire with damp diet and blood depression; self-made
Rupi Sanjie Decoction
(乳癖散结汤) for liver depression, stagnation of
Qi
and blood.
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