摘要
冠心病合并焦虑抑郁是临床常见双心疾病,发病率较高,焦虑抑郁作为冠心病独立危险因素,可严重影响冠心病患者的预后及生活质量,冠心病反复发作又可加重患者焦虑抑郁状态,临床治疗此类疾病多形神共调,双心同治。基于清代名医黄元御“人体气水循环以中气为轴,脾胃为升降之枢”的“枢轴运动”理论体系,认为中气衰弱,枢轴不运为冠心病合并焦虑抑郁发病的根本原因,从胃土不降,金水收藏失司,君相之火生炎所致阴虚、太阴不升,阳明不降所致气滞、水寒土湿,木郁下陷所致血瘀、土湿阳衰,水气不归正化所致痰饮等角度阐述冠心病合并焦虑抑郁的发病机制。临证之时以健运中土,行中气轮转之机,复脾胃清浊之位为主要制方思路,病于阴虚者,治以健运中土,敛金降逆以复其阴精之源;病于气滞者,治以斡旋中土,疏肝肃肺以畅气行之路;病于血瘀者,治以燥土暖水,升木达郁以除血瘀之弊;病于痰饮者,治以燥土泄湿,利气行郁以绝痰饮之根,以期为其临床诊疗提供参考。
Coronary heart disease combined with anxiety and depression is a common clinical double heart disease with a high incidence rate.As an independent risk factor of coronary heart disease,anxiety and depression can seriously affect the prog-nosis and quality of life of patients with coronary heart disease.Repeated attacks of coronary heart disease can also aggravate the anxiety and depression of patients.Clinical treatment of this kind of disease is multi-modal and coordinated.Based on the“piv-ot movement”theory system of HUANG Yuanyu,a famous doctor in the Qing Dynasty,“the human body's Qi and water cycle takes the central Qi as the axis,and spleen and stomach as the pivot of ascending and descending”,this paper believes that the weakness of the central Qi and the failure of the pivot are the root causes of coronary heart disease combined with anxiety and de-pression.This article elaborated on the pathogenesis of coronary heart disease complicated with anxiety and depression from the perspectives of failure to lower the stomach earth Qi,loss of the control of gold water,monarch fire and minister fire leading to Yin deficiency,failure of Taiyin ascending,failure of Yangming descending leading to Qi stagnation,water cold and earth dampness,collapse of wood stagnation leading to blood stasis,earth dampness and Yang failure,and failure to normalize water and Qi leading to phlegm and Yin.At the time of clinical treatment,the main idea of prescription is to strengthen the middle earth,promote the rotation of the central Qi,and restore the spleen and stomach to clear and turbid position.If the disease is due to Yin deficiency,it should be treated by strengthening the central soil,and collecting the gold and lowering the adverse to restore the source of Yin essence.If the disease is caused by Qi stagnation,it should be treated by mediating the middle earth,dredging liver and eliminating lung to smooth the way of Qi flow.If the disease is caused by blood stasis,it should be treated with drying the earth and war-ming water,and ascending the wood to relieve depression so as to remove blood stasis.If the disease is caused by phlegm and flu-id retention,it should be treated with drying the earth and eliminating dampness,and the root of phlegm and fluid retention should be removed by promoting Qi and resolving stagnation,so as to provide a reference for its clinical diagnosis and treatment.
作者
李增
张明雪
LI Zeng;ZHANG Mingxue(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第10期205-208,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家重点研发计划项目(2017YFC1700400,2017YFC1700401)
国家自然科学基金面上项目(81273698)
辽宁省特聘教授滚动支持项目(辽教函[2018]35号)。
关键词
黄元御
枢轴运动
冠心病
焦虑抑郁
HUANG Yuanyu
pivot movement
coronary heart disease
anxiety and depression
