韩延华教授从痰论治产后抑郁症临证经验

[目的]总结韩延华教授从痰论治产后抑郁症的临床经验,为临床治疗产后抑郁症提供新思路。[方法]以阐述中西医发病机理及治疗为切入点,从病因病机、辨证分型、用药特点等方面论述韩延华教授治疗产后抑郁症的学术观点和临床经验,并附验案举隅。[结果]韩延华教授认为痰邪是产后抑郁症的关键因素,责于肝脾肾三脏。脾肾亏虚,虚则生痰,肝气郁结,郁而化火,痰火互结,上扰清窍是其最终的结果。临床上多见于痰火上扰型、气郁痰阻型、脾虚痰凝型。治疗上始终以祛痰作为总纲,辨证治疗,气郁者当疏肝解郁以顺之,脾虚者当健脾祛痰以补之,痰火者当涤痰祛热以清之,临证加减,收效甚佳。所举验案为气郁日久,痰火上扰型,辨证准确,用药得当,疗效显著。[结论]韩延华教授从痰论治产后抑郁症理论独到,临床疗效显著,值得学习应用。

Professor HAN Yanhua's Clinical Experience in Treating Postpartum Psychosis from Phlegm

[Objective]To summarize Professor HAN Yanhua''s clinical experience in treating postpartum depression from phlegm theory and provide new ideas for clinical treatment of postpartum depression.[Methods]To elaborate the pathogenesis and treatment of traditional Chinese and western medicine as a starting point. Professor HAN Yanhua''s academic viewpoint and clinical experience in the treatment of postpartum depression were discussed from the aspects of etiology and pathogenesis, syndrome differentiation and typing, and medication characteristics, with some examples.[Result]Professor HAN Yanhua holds that phlegm pathogenic factor is the key factor of pathogenesis, which is responsible for the liver, spleen and kidney. Deficiency of spleen and kidney causes phlegm, stagnation of liver-Qi, depression and fire. The final result is that phlegm and fire are mutually knotted. In clinic, it is commonly seen in phlegm-fire disturbance type, Qi stagnation and phlegm obstruction type, spleen deficiency and phlegm coagulation type. Therapeutically, expectoration is always taken as the general principle and syndrome differentiation. Qi stagnation should be relieved by soothing liver and relieving depression, spleen deficiency should be invigorated by invigorating spleen and eliminating phlegm, phlegm and fire should be cleansed by eliminating phlegm and removing heat. Addition and subtraction with clinical symptoms have achieved good results. The cases cited are of long-term depression of Qi and disturbance of phlegm and fire. Dialectical accuracy, proper use of drugs, get significant effect.[Conclusion]Professor HAN Yanhua''s theory of treating postpartum depression from phlegm is original. The clinical curative effect is remarkable, and it is worth learning and applying.