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1.北京朝阳中西医结合急诊抢救医院急诊科,北京 100020
2.首都医科大学附属北京中医医院急诊科,北京 100010
Received:05 July 2024,
Published:25 August 2025
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刘勇志,姚卫海.柴胡加龙骨牡蛎汤合温胆汤论治郁病经验[J].北京中医药,2025,44(8):1071-1074.
LIU Yongzhi,YAO Weihai.Chaihu and Longgu MuliDecoction combined with Wendan Decoction in treatment of depression diseases[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):1071-1074.
刘勇志,姚卫海.柴胡加龙骨牡蛎汤合温胆汤论治郁病经验[J].北京中医药,2025,44(8):1071-1074. DOI: 10.16025/j.1674-1307.2025.08.026.
LIU Yongzhi,YAO Weihai.Chaihu and Longgu MuliDecoction combined with Wendan Decoction in treatment of depression diseases[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(08):1071-1074. DOI: 10.16025/j.1674-1307.2025.08.026.
郁病是由情志失调引起的一类精神疾患,其发病与肝胆关系密切,肝气郁结则内生诸邪,扰乱心神;胆腑不宁,则胆怯失勇,失于决断;肝胆合病则生郁病诸症。其治疗应以疏肝利胆、清热化痰为主,兼以重镇安神、理气活血、和解少阳之法,基本方以小柴胡汤及其类方和温胆汤及其类方加减为主。柴胡加龙骨牡蛎汤功擅和解少阳、疏肝利胆,方中多有重镇安神之品;温胆汤功擅和胃利胆、行气化痰。临床上两方合用并随症加减治疗郁病,疗效确切。
Depression diseases are a type of mental disorders primarily caused by emotional disturbances, closely related to the liver and gallbladder. When liver
qi
stagnates, various internal evils are generated, disturbing the spirit. When the gallbladder is unsettled, it loses courage and becomes timid, resulting in poor judgment. Liver-gallbladder disharmony gives rise to the symptoms of depression diseases. The treatment should primarily focus on soothing the liver, promoting bile flow, clearing heat, and resolving phlegm, while also incorporating methods such as calming the mind, regulating
qi
, promoting blood circulation, and resolving
shaoyang
imbalances. The main formulas include
Xiaochaihu
Decoction
and its derivatives, as well as
Wendan
Decoction
and its derivatives, with modifications.
Chaihu and Longgu Muli
Decoction
is especially effective in harmonizing
qi
, soothing the liver, and promoting gallbladder function, and it contains ingredients that strongly calm the mind.
Wendan
Decoction
is effective in harmonizing the stomach, promoting bile flow, circulating
qi
, and resolving phlegm, particularly excelling in clearing hea
t, resolving phlegm, and alleviating depression. The combination of these formulas, adjusted according to the symptoms, has a definite therapeutic effect on depression diseases.
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王燕 , 郑咏之 , 姚成增 . 张伯萸从脾胃论治心系疾病 [J ] . 中医临床研究 , 2021 , 5 ( 1 ): 72 - 74 。
王梓淞 , 林慧君 , 曹锐 . 方和谦论治失眠“和脏腑,安五神”经验解析 [J ] . 北京中医药 , 2023 , 42 ( 10 ): 1061 - 1064 .
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王震 . 马骏从脏腑论治郁病经验 [J ] . 山东中医杂志 , 2022 , 41 ( 4 ): 424 - 427,437 .
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王洋 , 赵继福 . 赵继福教授肝郁行滞汤治疗郁证的经验总结 [J ] . 中医临床研究 , 2023 , 15 ( 23 ): 78 - 81 .
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钟巍 , 姚卫海 . 柴胡加龙骨牡蛎汤加减治疗肝郁型失眠疗效观察 [J ] . 北京中医药 , 2018 , 37 ( 6 ): 562 - 564 .
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侯一鸣 , 郭峥 , 卞国本 , 等 . 温胆汤研究进展 [J ] . 中国中医基础杂志 , 2024 , 30 ( 1 ): 176 - 181 .
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高云丽 , 许二平 , 闫向丽 , 等 . 温胆汤类方治疗精神类疾病研究进展 [J ] . 中华中医药杂志 , 2023 , 38 ( 3 ): 1169 - 1172 .
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