Treatment of depression disease clinical thinking

YuanChen China's traditional Chinese medicine academy of sciences hospital gate

China's traditional Chinese medicine to

        Depressed disease is refers to the characteristic of close, qi stasis, viscera function disorder and depression due to the grief and indignation, characteristic is restless, chest full frowsty, threat rib pain, or irritability to cry, or pharyngeal such as a foreign body sensation, etc as the main clinical manifestations of a kind of disease, the incidence of the disease is increasing trend year by year. From clinical look, the disease of modern medicine in anxiety, depression, cardiac neurosis, hysteria, cholecystitis, irritable bowel syndrome and climacteric syndrome, etc. The author followed ZhaoZhiFu tutor professor clinical, found the clearly the treatment of this disease, medication accuracy, curative effect is distinct, is now the finishing as follows.

        Pathogeny and pathogenesis

        ZhaoZhiFu think depression disease is caused by the characteristic factors, such as anger, thought, sorrow, fear and other bad stimulation characteristic, long-term effect on human body, more than the human body the self-adjustment ability, gradually lead to the body qi stagnation, zang-fu organ dysfunction and come on, zhu Dan creek so-called "blood harmonic basic not born; a Fei depression, the disease was born the number". Visible characteristic factors in the occurrence of the disease in the process of the development is crucial, and clinical symptoms will then or light or heavy.

        Its pathogenesis is concerned, ZhaoZhiFu think depression disease hair, first of all make liver. Liver advocate drain, if not drain or too, all can lead to qi stagnation, thus affect other the dirty. Its prime mission is the masculine, etc. Drain too, can appear on the diseases with inverse, irascibility on inflammation, LianJi internal heat KangCheng, day long is injury and the Yin of the heart; Liver body Yin and Yang, irascibility exuberant is liver blood (Yin) deficiency, within the liver wind move, "the wind off bewildered, all belong to the liver, so it is all related with the disease of body tremor, dizzy the disease, all is liver disease. And b decyl homologous, liver disease long is easy injury and kidney Yin, YinSun and Yang, kidney Yang will also influenced by it; Eventually the two empty of Yin and Yang. The more soft license meal together outwardly submissive but inwardly evil-hearted, etc. Not drain, qi and blood stagnation, can lead to depression, chest distress, short short, breast pain and throat of foreign body sensation, etc.; Trapped spleen stomach, tend to cause the insufficiency of the spleen wet quickly, it may be associated with diarrhea fatigue, dementia, etc.; Time stomach kidney empty, and ultimately to Yang damage and Yin Yin and Yang, the two virtual.

        In addition, gas for blood (tianjin) handsome, gas line the blood line, gas line is tianjin line, so in the development of the disease, whether just card or soft card, all can have phlegmy resistance, blood stasis pathological factors throughout, and in turn affect the operation of qi and blood and aggravate the disease.

        Syndrome differentiation and treatment

        ZhaoZhiFu think more depressed disease because of "gas" is born, the main disease position in the liver, heart, spleen, involving the lung, kidney. So between the primary and secondary should be considered in the treatment of to be to "YuDaZhi wood, fire, earth YuFa took yu, JinYu drainage, water depression fold" for the land, which the Lord "from liver treatment", and to yangxin, or the spleen, or bedding lungs, or kidney. And see if blood stasis and phlegm obstruction symptoms or to and to invigorate the circulation of blood, phlegm. In short, the treatment principle, its this in the liver, its mark in his dirty, visceral involvement, there will be the primary and secondary, the treatment should distinguish specimen false or true, set your ease, differentiation of symptoms and signs to choose party drugs can only have a definite object in view.

        ZhaoZhiFu years of practical experience shows that firm soft differentiation theory treatment depression disease curative effect is distinct. According to the theory of firm soft syndrome differentiation, generally can be divided into two classes the four type: that is just certificate, the certificate. Firm soft and points false or true, just card of the empirical see more heart fire, just syndrome of deficiency syndrome see more heart Yin deficiency; The soft certificate for the stomach qi, soft syndrome of deficiency syndrome in spleen deficiency stomach.

        Just card in usually more masculine temperament, irritable, upset, or emotional, your voice loud, action quick man.

        The heart of the fire card clinical symptoms see more palpitation, chest pain, upset irritability, face red dizziness, insomnia, urine, stool stem node short red, red tongue and pulse number of string. Purging liver clearing away the treatment to give priority to. Choose herbs gardenia black bean tonga minus. Commonly used drugs is: gardenia, lobster sauce, cortex moutan, fructus forsythiae, bamboo leaf, mulberry leaf, chrysanthemum, etc. Darling the fire card often clamp sputum clamp bug, visible chest stuffy short, dark red tongue, moss yellow greasy. Can clear liver heat is given priority to, with two ChenShang add and subtract.

        Deficiency of Yin deficiency heart clinical symptoms see more palpitation, dizziness have a headache, upset, insomnia and have many dreams, and two eye dry, hot flash night sweats and red tongue less moss, vein string count. Treatment with soft liver yangxin is given priority to, more than formula selection of paeonia lactiflora liquorice decoction and cardiotonic bolus add and subtract, commonly used drugs is: peony, liquorice, Fried jujube benevolence, radix polygoni multiflori cane, salvia miltiorrhiza, dwarf lilyturf, platycladi seed, lily, etc. Heart Yin deficiency is often accompanied by hand performance, for the performance of the dizziness have a headache, tinnitus, top heavy. Can be in nourishing the liver Yin adding lead blood descending of the medicine such as red ochre, radix achyranthis bidentatae, etc. If time hand what have dynamic wind performance, such as tetany, vibrate, such as convulsion of disease, in nourishing the liver Yin basis out add wind town of liver medicine such as burnt magnet, tortoise plastron, born keel, raw oysters, mother of pearl, etc., add a small amount and gastric medicine such as sand benevolence, chicken's gizzard-membrane in case of Yin town product g cut the spleen and stomach.

        Soft card in usually temperament more outwardly submissive but inwardly evil-hearted, depression, depression, silent, behavior cautious man.

        The stomach qi card clinical symptoms see heart palpitations, chest distress, the good heave a deep sigh, chest pain, pain no place, wan abdominal distension full and red tongue moss white, vein string. Treatment with soothing the liver qi is given priority to, herbs radix bupleuri choose "shugan decoction" and scattered. Commonly used drugs is: radix bupleuri, rhizoma cyperi, fructus aurantii immaturus, green tangerine peel, stone calamus, Szechwan chinaberry, turmeric, etc. Stomach qi card much clamp wet clamp sputum clamp stasis, clamp wet visible bad breath, coating on the tongue white sticky; Clamp sputum visible pharyngeal adverse, coating on the tongue BaiHou; Clamp stasis visible threat department sting, tongue dark or ecchymosis, etc. The need to "shugan decoction" on the basis of the match with a small amount of qushi medicine such as white cardamom, or apophlegmatisant such as two ChenShang, or invigorate the circulation of blood medicine such as angelica, salvia miltiorrhiza.

        Deficiency of spleen deficiency syndrome stomach clinical see more heart palpitations, chest distress, short short, fatigue, lack of appetite nano stay, abdominal distension loose stool, burnout lazy speech, tongue reddish moss white, vein sink string fine. With the spleen nourishing blood treatment "shugan decoction" is given priority to. Herbs choose xiaoyao SAN add and subtract. Commonly used drugs is: radix bupleuri, radix paeoniae alba, angelica, tuckahoe, rhizoma atractylodis macrocephalae, mint, etc. Stomach and spleen deficiency syndrome more cold syndrome, visible like hot drinks, chills, brothers don't temperature, etc. On the basis of "shugan decoction" in the spleen plus a small amount of warm liver medicine such as cumin, radix linderae, dry ginger, etc.

        In a word, the certificate of the biggest characteristic is to tell patients the symptoms of many, and many see the actual inclusion, Yin and Yang parallel, therefore in the differentiation of symptoms and signs should combined with tongue vein disease figured out the main syndrome.

        Test case for knee

        Case a

        Yao so-and-so, male, 65 years old. Chief complaint palpitation 6 months, recently because of the quarrel with his family and palpitation aggravating, in his court examination did not see anomaly, accompanied by bosom is frowsty be agitated, giddy head bilges, binocular hair dry, threat rib expansion, little mei much dream, Mr, ErBian normal. The tip of the tongue is red, moss thin yellow, vein string count.

        Cause for heart Yin deficiency, treat with soft liver yangxin. In paeonia lactiflora liquorice decoction and cardiotonic bolus add and subtract rule.

        Agent: radix paeoniae alba 10 grams, salvia miltiorrhiza 30 grams, Fried jujube kernel 30 grams, cedar seed kernel 20 grams, nari 30 grams, poria cocos 30 grams, the fruit of Chinese wolfberry 20 grams, chrysanthemum 12 grams, mulberry leaf 10 grams, gardenia 10 grams, light black bean sauce 10 grams, magnet (first Fried) 30 grams, cinnamon 3 g, green tangerine peel 12 grams, galangal 6 grams, raw oysters (first Fried) 30 grams, roasted liquorice 3 g.

        Day 1 agent, water frying suit. Told the relax the mood, moderate exercise.

        Two diagnostics, palpitation reduce, there are still dizzy, night sleep difficulties. The original party add red ochre (first Fried) 30 grams, radix achyranthis bidentatae 30 grams, the clothing and agent.

        Three diagnostics, palpitation reduce, improve sleep. The original party with raw keel (first Fried) 60 grams, following suit.

        Continuous treatment again a month, keep the original strategy during do adjustment, symptoms basic recovery.

        According to the patients for liver Yin deficiency of Yin influence heart like, for liver for wind wood, the main pathogenesis, Tibetan blood, virtual is liver Yin deficiency, lost a leader caused dizzy, Yin deficiency anaemia, absent minded, clear orifices, alongwith the two eye hair dry, upset irritability, palpitation, insomnia, the tip of the tongue is red, moss thin yellow, vein string count are the heart Yin signs, patients element quick-tempered, belong to just the card deficiency syndrome. His own with radix paeoniae alba, radix salviae miltiorrhizae, Fried jujube benevolence, platycladi seed, such as lily soft liver and nourishes Yin to calm the nerves, mulberry leaf, gardenia, light black bean sauce, chrysanthemum and cool liver heat in addition to bother, magnet, oyster town to tranquilize the nerves, his own soft liver clear liver town liver as one is its characteristic.

        Case two

        LiuMouMou, female, 52 years old. Complained of insomnia much less dream more than 10 years, recently angry after aggravating. In the outer court was diagnosed as "depression status", who take prozac 1 year, symptoms ups and downs, XianZheng see depressed and less insomnia much dream, shortness of breath fatigue, lack of appetite for nani, xi hot, his face white, pale tongue, moss thin white, vein string fine.

        To cause stomach qi, two empty glove, cure to XieYu soothing the liver, the spleen to calm the nerves. In xiaoyao SAN add and subtract rule.

        Agent: radix bupleuri 12 grams, radix paeoniae alba 10 grams, poria cocos 30 grams, Fried rhizoma atractylodis macrocephalae 20 grams, fructus aurantii immaturus 12 grams, sweet with 10 grams, green tangerine peel 12 grams, dried tangerine or orange peel 12 grams, calamus 12 grams, cortex albiziae 15 grams, galangal 6 grams, Sue terrier 10 grams, Fried jujube kernel 30 grams, born keel (first Fried) 30 grams, raw oysters (first Fried) 30 grams, cinnamon 3 g, 3 g roasted liquorice.

        Day 1 agent, water frying suit.

        A month later, sleep obviously improved, appetite increase, the original party and tuber fleeceflower stem 30 grams, main radix astragali 30 grams, cumin 12 grams. Then take 1 months after recovery.

        According to the patients with depression, long injury and taste and heart, belongs to the stomach qi, two empty glove the card, is melancholia of complicated disease, patients with depression, combined with vein disease belong to the soft card deficiency syndrome. To XieYu with soothing the liver, the spleen to tranquilize the nerves, comprehensive treatment for the law. This square with radix bupleuri, radix paeoniae alba, fructus aurantii immaturus and rhizoma cyperi, green tangerine peel, stone calamus, cortex albiziae "shugan decoction" XieYu qi, galangal, tuckahoe, Fried the spleen of rhizoma atractylodis macrocephalae, Fried jujube benevolence, born keel, raw oysters yangxin, calming the liver to his own liver-discharging the spleen as one is its characteristic.

        Conclusion: ZhaoZhiFu think cause depression "emotion" pathogenic, by "gas" is born, the treatment should be from "liver" treatment, and run through the treatment of always, in the treatment of give attention to two or morethings to his dirty, and flexible use of invigorate the circulation of blood, phlegm, heat, tomifying qi and blood and psychological suggestion counseling, and other methods, make the liver drain gasification function returned to normal, neat, he dirty blood lift access has recovery. For clinical worker, is depressed disease can appear in any system disease, in case of development and outcome, only through the clinical sift condition and careful for ask for, careful verification disease, syndrome differentiation and treatment, choose party drugs will be more accurate, clinical curative effect will be significant.