| 陈晗雯,杨泽,刘瑜婷,夏永良.夏永良应用柴胡桂枝汤治疗中风后郁证经验介绍[J].浙江中西医结合杂志,2024,34(2): |
| 夏永良应用柴胡桂枝汤治疗中风后郁证经验介绍 |
| Analysis of XIA Yongliang’s Experience in Applying Chaihu Guizhi decoction in Treating the post-stroke depression |
| 投稿时间：2023-06-20 修订日期：2023-10-10 |
| DOI： |
| 中文关键词: 中风后郁证 柴胡桂枝汤 临证经验 医案 夏永良 |
| 英文关键词:post-stroke depression Chaihu Guizhi Decoction clinical experience medical records XIA Yongliang |
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| 中文摘要: |
| 目的：探讨夏永良老师应用柴胡桂枝汤治疗中风后郁证的临床经验。方法：收集并整理夏师治疗中风后郁证患者病例。分析中风后郁证病机及柴胡桂枝汤治疗特色，总结夏师诊治及用药经验，用典型验案论述夏师临证经验。结果：夏师认为，中风后郁证病机为肝胆枢机不利，气机不畅；三焦枢机不利，津液输布失常；脾胃枢机不利，气血生化不足。柴胡桂枝汤可转利枢机，畅气机，通津液，和气血。所举验案，辨为枢机不利，阴虚血少之证，治以转枢机，益阴血，方用柴胡桂枝汤加减，后续根据病情变化，辨证加减，收效甚佳。结论：夏师用柴胡桂枝汤治疗中风后郁证，临证加减灵活，标本兼治，“话疗”疏导患者情绪，其临床经验值得学习和借鉴。 |
| 英文摘要: |
| Objective：To discuss the clinical experience of Professor Xia Yongliang in applying Chaihu Guizhi decoction in the treatment of post-stroke depression. Methods：Collected and collated the cases of patients with post-stroke depression symptoms treated by Professor Xia in his outpatient clinic.Reviewed the literature and applied the pivotal mechanism theory to analyze the intrinsic etiology and mechanism of post-stroke depression symptoms and the treatment characteristics of Chaihu Guizhi decoction, and summarized Professor Xia"s relevant diagnosis and treatment experience and medication characteristics, and further discussed Professor Xia"s clinical experience by analyzing a typical cases. Results：Professor Xia believes that the pathogenesis of post-stroke depression lies in the adverse central organ of the liver and gallbladder, which leads to the failure of qi flow; The operation of "SanJiao" is not smooth, which leads to the failure of fluid distribution; and The digestion of the spleen and stomach do not work well, which leads to the deficiency of qi and blood. Chaihu Guizhi decoction take the function of Xiao Chai Hu decoction to promote the flow of fluids and Gui Zhi decoction to harmonize the YingWei, and the combined use of the two formulae can turn the benefit to smooth the Qi flow, promote the flow of fluids and harmonize the Qi and Blood. In the case cited, it was identified as the evidence of unfavorable pivot and deficiency of yin and blood, and the treatment was based on sparing the pivot, benefiting yin and replenishing blood, choosing Chai Hu Gui Zhi decoction with addition and subtraction, and according to the change of disease, combining with the medicine of nourishing blood, moving qi and resolving phlegm, which was very effective.Conclusion：Professor Xia Yongliang used Chaihu Guizhi decoction to treat the symptoms of post-stroke depression, taking into account both the symptoms and the root cause, and paid attention to "talking therapy" to ease the patient"s emotions through consultation. His clinical experience is worth studying and learning from. |
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