【摘要】：糖尿病合并抑郁癥是指患糖尿病(DM)之后出現(xiàn)的抑郁癥,主要表現(xiàn)為精神抑郁、情緒悲觀、思維遲緩、興趣減退等。本病在臨床中十分常見,可見于糖尿病的任何時期,中醫(yī)將本病歸屬為“消渴合并郁病”范疇。吾師李小娟教授從醫(yī)近三十年,勤求古訓,博采眾方,根據(jù)多年臨床經(jīng)驗,將消渴合并郁病定為本虛標實之證,本虛者:以氣虛、陰虛為本,并貫穿疾病的各個階段;標實者:痰濁、瘀血、熱邪等病理產(chǎn)物,三者相互博結(jié),氣血津液運行不暢,結(jié)于胸膈、清竅,而出現(xiàn)精神抑郁、表情淡漠,喜歡獨處,易哭或精神亢奮、性情急躁、心煩易怒、不寐等臨床表現(xiàn)。李小娟教授主張以化痰瘀、調(diào)氣血為本病的基本治療原則,以靶向辨證為本病的辨治思想,臨床療效顯著。目的:探究李小娟教授辨證治療消渴合并郁病的臨床經(jīng)驗,進行歸納與總結(jié)。材料與方法:通過跟師,進行臨床學習并收集相關(guān)病例,進而了解導師對消渴合并郁病的中醫(yī)病因病機的看法、辨證論治、及臨床用藥規(guī)律,最終分析總結(jié)出導師治療消渴合并郁病的臨證經(jīng)驗。結(jié)果:1.李小娟教授認為消渴合并郁病病位在于肝、脾兩臟,病機特點為本虛標實。本虛為:氣陰兩虛;標實為:痰濁、瘀血、熱邪等病理產(chǎn)物,三者相互博結(jié),氣血津液運行不暢,結(jié)于胸膈、清竅。2.李小娟教授認為,消渴日久,發(fā)為郁病,標實的“痰瘀”貫穿本病始末。痰濁與瘀血不僅是病理產(chǎn)物,又可作為致病因素加重本病病情。3.李小娟教授主張以化痰瘀、調(diào)氣血為本病的治療原則,以靶向辨證為本病的辨治思想,治療上主張效方加效藥,善用經(jīng)典,療效顯著。結(jié)論:李老師主張化痰瘀、調(diào)氣血治療消渴合并郁病,臨床療效顯著,具有臨床指導意義,值得廣泛應用。
[Abstract]:Diabetes mellitus combined with depression refers to depression after suffering from diabetes mellitus (DM), mainly manifested in mental depression, emotional pessimism, slow thinking, decreased interest and so on. This disease is very common in clinical practice, can be seen in any period of diabetes, Chinese medicine classified the disease as "Xiaoke combined with depression" category. Professor Li Xiaojuan, my teacher, has been in medicine for nearly 30 years, often seeking ancient admonition and collecting many prescriptions. According to the clinical experience of many years, the combination of thirst and depression is regarded as the syndrome of deficiency of essence and reality, which is based on deficiency of qi, deficiency of yin, and runs through every stage of the disease; Standard solid: phlegm turbid, blood stasis, heat evil and other pathological products, the three mutual knot, blood and fluid flow is not smooth, knot in chest diaphragm, clear orifices, and appear mental depression, expression indifferent, like to be alone, easy to cry or hyperactive, temperament irritable, Perturbed irritability, insomnia and other clinical manifestations. Professor Li Xiaojuan advocates the basic treatment principle of resolving phlegm and blood stasis, regulating qi and blood as the basic treatment principle and the thought of differentiating and treating the disease with the aim of syndrome differentiation, and the clinical curative effect is remarkable. Objective: to explore the clinical experience of professor Li Xiaojuan in treating thirst with depression. Materials and methods: through clinical study and collection of related cases, the tutor's views on TCM etiology and pathogenesis, syndrome differentiation and treatment, and clinical drug use were studied. Finally, the clinical experience of the tutor in the treatment of Xiaoke combined with depression was summarized. The result is 1: 1. Professor Li Xiaojuan thinks that the location of Xiaoke combined with depression lies in the liver and spleen. This deficiency is: deficiency of qi and yin; standard is: phlegm turbidity, blood stasis, heat evil and other pathological products, the three mutually abundant knot, Qi and blood body fluid operation is not smooth, knot in chest diaphragm, clear orifices. 2. Professor Li Xiaojuan believes that the long period of thirst, hair depression, the standard "phlegm and blood stasis" throughout the disease. Phlegm turbidity and blood stasis are not only pathological products, but also can be used as pathogenic factors to aggravate the disease. Professor Li Xiaojuan advocated the principle of resolving phlegm and blood stasis, regulating qi and blood as the principle of treating this disease, and treating the disease with the aim of differentiation of symptoms and signs. Conclusion: teacher Li advocated resolving phlegm and blood stasis, regulating qi and blood to treat thirst with depression.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R249;R255.4;R277.7
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本文編號：2170342