刚柔辨证治疗郁证四法.pdf

刚柔辨证治疗郁证四法 李健1,2赵志付1 1中国中医科学院广安门医院，北京1000532中国中医科学院，北京100700 摘要：本文以郁证病机特点入手，从其社会-心理-伦理角度进行辨证论治，提出采用刚柔辨证诊疗该病， 将患者的情志因素与症状总和到诊断之中。其辨证可分为两纲四型十六证，其中四型分别为：刚实证、刚虚证、柔 实证、柔虚证；治疗上分别可用4种治法：泻肝清心安神法、柔肝养心法、疏肝理气法、疏肝健脾法，并各举一则 病案以为说明。再从凝练证型，病证结合；心身同治、内外兼顾两方面来阐述刚柔辨证四法治疗郁证的优势所在。 关键词：刚柔辨证；四法；郁证；中医 Fourtreatmentmethodsondepressionsyndromeinrigid-gentlesyndrome differentiationsystem LIJian1,2ZHAOZhi-fu1 1GuanganmenHospital,AcademyofChineseMedicineSciences,Beijing100053,China 2AcademyofChineseMedicine Sciences,Beijing100700,China Abstract:Thearticlestartedfromthepathologicalcharacteristicsofdepression.Itusedrigid-gentlesyndrome differentiationsystemtotreatdepressionaccordingtosyndromedifferentiationinsocial-psychological-ethicalperspective,which alsomadetheconsiderationofboththeemotionalfactorsandsomaticsymptoms.Therewere2classes,4itemsand16families inthedifferentiationsystem,4itemswere:rigid-excesssymptom;rigid-deficiencysymptom;gentle-excesssymptom;gentle- deficiencysymptom.Fourtreatmentmethodscouldberespectivelyused:methodofpurgingtheliver,clearingtheheartand tranquilizingthemind;methodofsofteningtheliverandnourishingtheheart:methodofsoothingliverandregulatingqi;method soothingtheliverandfortifgingthespleen.Andtherewerefourcaseswhichusedastheillustrations.Itexplainedtheadvantages offourtreatmentmethodsoftherigid-gentlesyndromedifferentiationintwoaspects:onewasthesystemiccombinationofthe diseaseandsyndrome,andtheotherwasthecombinationofthepsychologicalfactorsandsomaticfactors. Keywords:Rigid-gentlesyndromedifferentiationsystem;Fourtreatmentmethods;Depressionsyndrome;Traditional Chinesemedicine -1530· 2013，V01．28，No．5 中华中医药杂志(原中国医药学报)2013年5月第28卷第5期CJTCMP，May