基于“阴阳跷脉”理论探讨针刺治疗卒中后抑郁

Exploration on Acupuncture Treatment for Post-Stroke Depression Based on the Theory of Yin and Yang Qiao Vessels

摘要: 卒中后抑郁(PSD)是以抑郁症状为主要表现的脑卒中后的常见难治性并发症，具有复发率高、自杀率高、危害性大等特点。中医学认为PSD发生本于卒中而后发抑郁，本病属因病致郁，而肾精亏虚、脑神失用、心失所养为卒中后抑郁根本之所在。目前跷脉理论被广泛熟知，其循行与脑、心、肾、脾等脏腑相络属，且与卒中后情绪异常等核心症状直接相关。故本文以“阴阳跷脉”理论为切入点，探讨针刺治疗PSD的理论内涵、病因病机及临床治疗，以期为中医药防治PSD提供参考依据。

Abstract: Post-stroke depression (PSD) is a common and refractory complication following stroke, characterized by prominent depressive symptoms, along with a high recurrence rate, elevated suicide risk and severe harm. In traditional Chinese medicine (TCM), PSD arises secondary to stroke, belonging to the category of depression caused by illness; its fundamental pathogenesis lies in kidney essence deficiency, dysfunction of the brain spirit, and failure of the heart to be nourished. At present, the theory of the Qiao Vessels (Yinqiao and Yangqiao Vessels) is widely recognized. The meridians of the Qiao Vessels connect with the brain, heart, kidney, spleen and other zang-fu organs, and are directly associated with the core symptoms of PSD such as emotional disorders after stroke. Therefore, taking the theory of the Yin and Yang Qiao Vessels as the starting point, this paper explores the theoretical connotation, etiology, pathogenesis and clinical treatment of acupuncture for PSD, aiming to provide a reference for the prevention and treatment of PSD with TCM.