探讨老年期抑郁症的中医病机和治疗原则

抑郁症是一种高发病率、高复发率、高致残率、高疾病负担的全球性疾病,中医药治疗抑郁症在《中国抑郁障碍防治指南》(第二版)中得到推荐,进一步证明中医在抑郁症药物治疗方面确有疗效,但目前对于抑郁症的中医病机、治疗原则及证型分布尚无统一共识。本文从老年人的生理特点、抑郁症的临床表现和疾病发展规律出发,结合医家临床经验、典籍等,试分析与探讨老年期抑郁症的中医病机肾虚和中焦枢机不利,并在此基础上提出老年期抑郁症的治疗原则即补肾是重点,调畅中焦枢机为关键,期望通过本文对老年期抑郁症主要病机和治疗原则的探索与总结能对临床实践有所裨益。

Exploration of the pathogenesis and treatment principle of senile depression in traditional Chinese Medicine

Depression is a global disease with high incidence,high recurrence rate,high disability rate and high disease burden.The treatment of depression with traditional Chinese medicine has been recommended in the Chinese guidelines for the Prevention and treatment of Depression(second Edition).It is further proved that traditional Chinese medicine is effective in the drug treatment of depression,but at present,there is no unified consensus on the pathogenesis,treatment principles and syndrome distribution of depression.Based on the physiological characteristics of the elderly,the clinical manifestations of depression and the law of disease development,combined with doctors'clinical experience and books,this paper tries to analyze and discuss the TCM pathogenesis of late life depression—the kidney deficiency and the inharmonious of middle-jiao.On this basis,it puts forward the treatment principle of senile depression-tonifying the kidney is the key point,adjusting the middle-jiao is the key;It is expected that through the exploration and summary of the main pathogenesis and treatment principles of senile depression,it will be beneficial to the clinical practice.