蒋健从郁论治畏寒的学术观点及临床经验
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摘要
蒋健教授指出郁证性畏寒的临床特征主要包括情志致病、出现情志症状、伴随症状"异彩纷呈",畏寒症状夸张怪异以及从郁论治有效等。郁证性畏寒存在多种郁证形态,以隐性郁证居多。看清和诊断隐性郁证是临床难点,需要学习和把握诊断隐性郁证的重要线索。作出郁证的诊断是在郁证性畏寒诊疗中最重要的一环。通过掌握郁证的形态及诊断有助于摆脱固有僵化的诊疗思路,治疗不宜温阳而宜解郁。从郁论治畏寒主要以疏肝理气、养心安神为主,同时指出临证需要圆机活法,随症加减,并扩展了活血化瘀、调和营卫等解郁治法,以期对同道有所裨益。
Prof. Jiang Jian pointed out that the clinical feature of depression-induced chills includes emotional disorders,mental symptoms,chills,effective treatment,etc. The depression-induced chills has many depression features,manifested as recessive depression. It is the difficulty in the clarification and diagnosis of recessive depression. The main clue of its diagnosis should be studied. The diagnosis of depression is the most important link during the treatment of depression-induced chills. Mastering the depression conditions and diagnosis may get rid of the rigescent diagnostic ideas. Relieving depression should be the treatment principles in this kind of chills,rather than warming yang. The treatment of depression-induced chills should focus on smoothing liver qi,nourishing the heart and tranquilizing the mind. Additionally,the principles as activating blood circulation,removing stasis and regulating the nutrient and the defensive systems were introduced for the flexible application according to the specific symptoms.
Prof. Jiang Jian pointed out that the clinical feature of depression-induced chills includes emotional disorders,mental symptoms,chills,effective treatment,etc. The depression-induced chills has many depression features,manifested as recessive depression. It is the difficulty in the clarification and diagnosis of recessive depression. The main clue of its diagnosis should be studied. The diagnosis of depression is the most important link during the treatment of depression-induced chills. Mastering the depression conditions and diagnosis may get rid of the rigescent diagnostic ideas. Relieving depression should be the treatment principles in this kind of chills,rather than warming yang. The treatment of depression-induced chills should focus on smoothing liver qi,nourishing the heart and tranquilizing the mind. Additionally,the principles as activating blood circulation,removing stasis and regulating the nutrient and the defensive systems were introduced for the flexible application according to the specific symptoms.
引文
[1]蒋健.郁证发微(六)——郁证畏寒论[J].上海中医药杂志,2016,50(1):11-14.
[2]蒋健.郁证发微(一)——郁证形态论[J].上海中医药杂志,2015,49(8):4-7.
[3]蒋健.郁证发微(二)——郁证诊断论[J].上海中医药杂志,2015,49(9):3-6.
[4]蒋健.郁证发微(四)——隐性郁证论[J].上海中医药杂志,2015,49(11):4-7.
[5]陈绍云,姚自强,陈梓朗,等.甘麦大枣汤合四逆散治疗肝郁脾虚型抑郁症的临床研究[J].中国医学工程,2016,24(5):107-108.
[6]韩永祥,汪红兵.四逆散加味治疗功能性消化不良伴抑郁状态30例疗效观察[J].北京中医药,2011,30(6):457-458.
[7]胡海燕,徐志伟,敖海清,等.四逆散影响慢性应激抑郁模型大鼠行为学研究[J].中华中医药杂志,2016,31(1):271-274.
[8]孙文军,唐启盛,曲淼.从血府逐瘀汤看王清任治疗焦虑症的思想[J].吉林中医药,2011,31(1):1-3.
[9]李显雄,胡建芳,余志辉,等.血府逐瘀汤治疗中风后抑郁或焦虑临床研究[J].中医药临床杂志,2013,25(8):676-677.
[10]刘英,徐爱军,张玉蕊.血府逐瘀汤对抑郁症大鼠模型的治疗作用及海马5-羟色胺及5-羟色胺1A受体表达的影响[J].时珍国医国药,2015,26(4):867-868.
[11]张兴.从营卫论治心脏神经症[J].长春中医药大学学报,2011,27(3):390-391.
[12]董子强,翟文瑜.营卫失和与抑郁症昼夜节律关系探讨[J].河南中医,2014,34(4):585-586.
[2]蒋健.郁证发微(一)——郁证形态论[J].上海中医药杂志,2015,49(8):4-7.
[3]蒋健.郁证发微(二)——郁证诊断论[J].上海中医药杂志,2015,49(9):3-6.
[4]蒋健.郁证发微(四)——隐性郁证论[J].上海中医药杂志,2015,49(11):4-7.
[5]陈绍云,姚自强,陈梓朗,等.甘麦大枣汤合四逆散治疗肝郁脾虚型抑郁症的临床研究[J].中国医学工程,2016,24(5):107-108.
[6]韩永祥,汪红兵.四逆散加味治疗功能性消化不良伴抑郁状态30例疗效观察[J].北京中医药,2011,30(6):457-458.
[7]胡海燕,徐志伟,敖海清,等.四逆散影响慢性应激抑郁模型大鼠行为学研究[J].中华中医药杂志,2016,31(1):271-274.
[8]孙文军,唐启盛,曲淼.从血府逐瘀汤看王清任治疗焦虑症的思想[J].吉林中医药,2011,31(1):1-3.
[9]李显雄,胡建芳,余志辉,等.血府逐瘀汤治疗中风后抑郁或焦虑临床研究[J].中医药临床杂志,2013,25(8):676-677.
[10]刘英,徐爱军,张玉蕊.血府逐瘀汤对抑郁症大鼠模型的治疗作用及海马5-羟色胺及5-羟色胺1A受体表达的影响[J].时珍国医国药,2015,26(4):867-868.
[11]张兴.从营卫论治心脏神经症[J].长春中医药大学学报,2011,27(3):390-391.
[12]董子强,翟文瑜.营卫失和与抑郁症昼夜节律关系探讨[J].河南中医,2014,34(4):585-586.