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(三十)——郁证泄泻论[J]. 上海中医药杂志, 2018,52(1):5-10.
JIANG Jian. Series of discussion on depression syndrome(30):Diarrhea due to depression syndrome[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(1):5-10.
探讨郁证性泄泻的病脉证治。由情志因素导致或加重的泄泻,且从郁论治或辅以从郁论治有效者,概为郁证性泄泻,主要包括怒泄、惊泻、肝泄以及心劳、脾劳、肺劳泄泻等类型。其病变脏腑主要涉及肝、心、脾、肺;病机涉及肝气郁结、胆虚受惊、思虑伤脾、费神劳心、悲愁伤肺等多端,可交杂出现。根据郁证性泄泻的不同类型有多种的治疗方法,包括疏肝解郁、壮胆镇惊、养心安神、养脾补肺、调整气机等,其中尤以疏肝抑木、强脾实土最为重要而常用,心理宽慰、调整患者生活态度等非药物治疗的作用亦不可忽视。现代医学中由精神心理因素引起的功能性腹泻、肠易激综合征等功能性胃肠疾病以及精神心理障碍类疾病所致腹泻,大抵属于郁证性泄泻的范畴。
This paper discusses the syndrome and treatment of diarrhea due to depression syndrome. Diarrhea,triggered or aggravated by emotional factors and treated effectively based on or combined with relieving depression,can be summarized as diarrhea due to depression syndrome. It mainly contains angry diarrhea,frightened diarrhea,hepatic diarrhea,and diarrhea due to overstrain of heart or spleen or lung. The pathological zang-fu viscera mainly involve the liver,heart,spleen and lung. And the pathogenesis is related to stagnation of liver qi,deficiency of gallbladder qi due to being frightened,worrying damaging the spleen,spiritual exhaustion impairing the heart,grief consuming the lung and so on,which can present at the same time. According to different patterns of diarrhea due to depression syndrome,there are many kinds of treatment,including dispersing stagnated liver qi for relieving qi stagnation,emboldening the courage and relieving convulsion,nourishing heart for tranquillization,tonifying the spleen and invigorating the lung,regulating qi movement and so on. Among the therapy of harmonizing the liver and spleen is the most important and commonly used. And the role of non-drug therapy,such as psychological counseling and adjusting life attitude of patients,also cannot be ignored. In modern medicine,functional diarrhea,irritable bowel syndrome and other functional gastrointestinal disorders induced by psychological factors,as well as diarrhea caused by mental disorders,can be generally classified in the category of diarrhea due to depression syndrome.
郁证泄泻肝泄病因病机从郁论治
depression syndromediarrheahepatic diarrheaetiology and pathogenesistreatment based on relieving depression
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