1. 上海中医药大学附属曙光医院,上海,200021
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蒋健. 郁证发微(十七)——郁证眩晕论[J]. 上海中医药杂志, 2016,50(12):4-9.
JIANG Jian. Dizziness due to depression syndrome[J]. Shanghai Journal of Traditional Chinese Medicine, 2016,50(12):4-9.
探讨郁证性眩晕的病脉证治,并提出“无郁不作眩”的学术观点。郁证性眩晕的病机主要有肝郁、痰浊、正虚以及瘀血等,均可由情志病因引发。情志不遂最易导致肝气郁结,化火生阳变风皆源于此。通过对朱丹溪“无痰不作眩”和张景岳“无虚不作眩”观点进行深入剖析,发现部分痰、虚作眩乃因郁演变而成。郁证性眩晕有一定的临床特征可资辨认。从肝论治、补虚、化痰、化瘀都可以治疗郁证性眩晕,不同程度的疏肝理气、养心安神可以作为各种治疗的基础性法则。郁证性眩晕主要包括现代医学的精神性眩晕,若含病郁同存者在内,或可占到临床眩晕患者的半数以上。
This paper discussed the syndrome and therapy of dizziness due to depression syndrome and put forward the academic point that “without depression,there would be no dizziness”. The pathogenesis of dizziness due to depression syndrome include stagnation of liver-qi,phlegm-turbidity,deficiency of vital qi and blood stasis. All of these can be caused by emotional factors. Negative emotions can most easily lead to stagnation of liver-qi,and then transform into liver-fire,liver-yang and liver-wind. By analyzing the detailed illustration of Zhu Danxi’s point that “without phlegm,there would be no dizziness” and Zhang Jingyue’s point that “without deficiency,there would be no dizziness”,the fact that a part of dizziness closely related to phlegm syndrome and deficiency syndrome is actually aroused by depression. And some identifiable clinical manifestations of dizziness due to depression syndrome can be found. In terms of the treating principles of dizziness due to depression syndrome,regulating the liver and restoring the deficiency,dispelling phlegm and removing blood stasis can help to cure and relieve the symptom. And varying degrees of soothing liver and regulating qi,tranquilizing mind and soothing nerves,can be considered as routine treatment of multiple therapies. Dizziness due to depression syndrome mainly contains the area of psychological dizziness in modern medicine. If the coexistence of diseases and depression syndrome is contained,the dizziness due to depression syndrome may account for over half of clinical patients suffered from dizziness.
郁证眩晕病因病机情志精神性眩晕
depression syndromedizzinessetiology and pathogenesisemotionpsychological dizziness
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