郁证发微(四十)——郁证绝经前后诸证论

七情内伤引起的绝经前后诸证称为郁证性绝经前后诸证,其临床表现主要包括躯体症状和精神症状两大类,其中躯体症状又可分为月经紊乱类和非月经紊乱类。肝气郁结、心肝火旺、气血亏虚、痰瘀阻滞、阴虚风动、肝郁脾虚等为郁证性绝经前后诸证的常见病机。当代中医已经逐渐意识到郁证性绝经前后诸证的存在,治疗不再仅仅局限于补肾益天癸,而是越来越多开始运用疏肝解郁、养心安神等从郁论治或辅助从郁论治的方法。现代研究表明,社会心理因素可影响围绝经期综合征的发病,抗抑郁、激素补充以及心理认知疗法有助于缓解其临床症状,为郁证性绝经前后诸证学说提供了的有力支持。

Series of discussion on depression syndrome (40): Premenopausal syndrome due to depression syndrome

Premenopausal syndrome due to depression syndrome is premenopausal syndrome induced by internal injury caused by excess of seven emotions. Its clinical manifestations include physical symptoms and mental symptoms. Physical symptoms can be divided into menstrual disorders and non-menstrual disorders. Stagnation of liver qi,hyperactivity of heart-liver fire,deficiency of qi and blood,phlegm stasis,stirring wind due to yin deficiency,stagnation of liver qi and spleen deficiency and so on,all of which is the common pathogenesis of premenopausal syndrome due to depression syndrome. Contemporary Chinese medicine has gradually realized the existence of premenopausal syndrome due to depression syndrome. The treatment is no longer confined to tonifying kidney,but began to use more and more therapies based on relieving depression,such as dispersing stagnated liver qi for relieving qi stagnation,nourishing blood for tranquillization. Modern studies have shown that psychosocial factors can affect the onset of perimenopausal syndrome,and anti-depression,hormone replacement and psychological cognitive therapy can help to relieve the clinical symptoms,which is the strong evidence for premenopausal syndrome due to depression.