| 摘要: |
| 目前大多數中醫學者對心臟神經官能癥的發病與治療多從心、肝、脾、腎出發，較少論及肺。從心肝肺影響氣血運行的角度，以陰陽、五行、精氣血、津液神及經絡學說為工具，通過論述肝與肺的功能及生理病理特性，即“肺藏魄”“肺在聲為哭”“在志為悲”“肝主疏泄”“肝為五臟之賊”，生理上，心肝相生為母子，行血與藏血互用；心肺互制同居上焦，氣血互用；肝肺互制，龍虎回環調暢氣機。病理上，肝在五行屬木，木易郁而心火塞，從而乘肺金致肺氣虛。同時結合現代研究，提出心臟神經官能癥起于肝郁，而肝郁肺虛是心臟神經官能癥的病機演變結局之一的觀點，并提出論治心臟神經官能癥當需辨證論治，對于肝郁肺虛證的患者可疏其肝郁、補其肺氣。 |
| 關鍵詞: 心臟神經官能癥 肝郁 肺氣虛 |
| DOI：10.11656/j.issn.1672-1519.2023.05.12 |
| 分類號:R749.7 |
| 基金項目:中國中醫科學院科技創新工程項目（CI2021B001）；中央級公益性科研院所基本科研業務費專項資金資助項目（YZ-202156）。 |
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| Theoretical discussion on treating cardiac neurosis from liver depression and lung deficiency |
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TIAN Xiaoxin, DING Ning, WANG Yongtao, XU Shijie
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Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
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| Abstract: |
| At present, most Chinese medicine practitioners treat cardiac neurosis (CN) from the heart, liver, spleen and kidney, rarely discuss the lung. And this article uses the hexagrams and the theory of the five elements as tools, from the perspective of the heart, liver and lung's movement of qi and blood and discusses the functions and physiological and pathological characteristics of the liver and lungs, namely, "lung holds the soul" "lung is crying" and "lung is determined to be sad" "liver governs dispersal" "liver is the thief of the five internal organs". Physiologically, the heart and the liver are born as mother and child, the blood circulation and storage are mutually used; the heart and lungs interact with each other in shangjiao and the qi and blood are mutually used. Liver and lungs interact with each other system, the dragon and tiger loop to adjust the air machine. Pathologically, the liver belongs to the wood in the five elements and the wood is easy to be stagnant and the heart is blocked by fire, which leads to lung qi deficiency by taking advantage of the lung gold. Furthermore, it is proposed that CN originates from stagnation of the liver and liver stagnation and lung deficiency is one of the outcome of the pathogenesis of CN. It is also proposed that the treatment of CN should be based on syndrome differentiation. For patients with liver stagnation and lung deficiency, lung qi can be supplemented and liver can be soothed and gloomy. At the same time, it discusses its specific treatment methods based on the theory of luck and depression, the experience of ancient physicians and modern classic cases, in order to provide a new perspective and reference for the clinical treatment of CN. |
| Key words: cardiac neurosis liver depression lung qi deficiency |
