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1.甘肃中医药大学中西医结合学院(甘肃 兰州 730000)
2.天水市中医医院重症医学科(甘肃 天水 741000)
3.甘肃省中医药研究院心内科(甘肃 兰州 730050)
兰园媛,女,硕士研究生,主要从事中西医结合防治心血管疾病研究工作
吴荣,主任医师,硕士研究生导师;E-mail:wurong01@163.com
收稿:2025-09-23,
网络首发:2026-08-03,
纸质出版:2026-08-10
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兰园媛,唐亚芬,白彩瑞,等.张志明应用升阳益胃汤辨治抑郁症的临证经验[J].上海中医药杂志,2026,60(8):54-57.
Lan Yuanyuan,Tang Yafen,Bai Cairui,et al.Zhang Zhiming's clinical experience in applying Shengyang Yiwei Decoction for pattern‑based diagnosis and treatment of depressive disorder[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(8):54-57.
兰园媛,唐亚芬,白彩瑞,等.张志明应用升阳益胃汤辨治抑郁症的临证经验[J].上海中医药杂志,2026,60(8):54-57. DOI: 10.16305/j.1007-1334.2026.z20250923006.
Lan Yuanyuan,Tang Yafen,Bai Cairui,et al.Zhang Zhiming's clinical experience in applying Shengyang Yiwei Decoction for pattern‑based diagnosis and treatment of depressive disorder[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(8):54-57. DOI: 10.16305/j.1007-1334.2026.z20250923006.
介绍张志明教授运用升阳益胃汤辨治抑郁症的临证经验。张教授提出抑郁症核心病机始于脾胃虚弱,清阳不升,致水谷精微不归正化,神机失养;继而中焦纳运失常,痰浊内蕴,阻碍阳气生发,令神机颓废;加之肝郁失疏,横逆乘脾,气滞痰浊交互为患,加剧阳气郁遏,导致神机失司,终发为郁证。临证主张从脾胃立论,以“培土升阳,疏肝达郁”为法,以升阳益胃汤为主方,尤重风药在升阳、疏肝、胜湿中的妙用;强调临证化裁,择时服药,配合心理疏导,综合干预以增效,为突破抑郁症西药治疗瓶颈和拓展中医辨治思路提供新途径。
This paper introduces Professor Zhang Zhiming's clinical experience in treating depression with Shengyang Yiwei Decoction. Professor Zhang proposes that the core pathogenesis of depressive disorder is primarily attributed to deficiency of the spleen and stomach, which leads to failure of clear yang to ascend. This pathological mechanism impairs the transformation, transportation, and distribution of water and grain essence, ultimately resulting in reduced mental vitality and spiritual activity. Subsequent dysfunction of the middle jiao promotes the accumulation of phlegm-turbidity, further obstructing the production and flow of yang qi and aggravating mental fatigue. Accompanying liver qi stagnation and spleen constraint exacerbate this condition by inducing additional qi stagnation and phlegm accumulation, which collectively contribute to yang obstruction and mental depression.The treatment principle emphasizes strengthening the spleen, uplifting yang, and soothing liver qi stagnation. Shengyang Yiwei Decoction is used as the core prescription, which distinctively incorporates wind-dispersing herbs to activate yang, regulate the liver, and resolve dampness. The therapeutic approach also highlights the importance of accurate syndrome differentiation, tailored application of herbal medicine, psychological support, and integrated intervention to improve clinical outcomes. This strategy not only addresses the multifactorial pathogenesis of depressive disorder but also expands the scope of traditional Chinese medicine-based pattern differentiation and treatment, offering a complementary alternative to conventional Western antidepressant therapies.
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刘慧慧 , 胡国恒 , 刘建和 , 等 . 王行宽教授运用升阳益胃汤辨治慢性肠炎临床经验 [J]. 时珍国医国药 , 2024 , 35 ( 2 ): 469 - 471 .
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