基于“心藏神、主血脉”理论探讨焦虑抑郁的中医治疗

Exploring Traditional Chinese Medicine Treatment for Anxiety and Depression Based on the Theory of “Heart Storing Spirit and Governing Blood Vessels”

摘要: 焦虑抑郁是临床常见的精神疾病，随着激烈的社会竞争、学习工作生活压力的增大，长期处于焦虑抑郁状态，将对个人生活质量和身心健康造成极大影响，严重时甚至导致自杀。中医认为，“心藏神”是机体生理功能的核心，它是指人的神志活动。而“心主血脉”是指心气推动和调节血液循行于脉中，发挥充养全身的作用。心具有主宰五脏六腑、形体官窍等一切生理活动和精神意识思维活动的功能。中医药治疗焦虑抑郁具有独特优势，采用中药复方、针灸及穴位按摩等方法治疗焦虑抑郁疗效显著。目前临床上焦虑抑郁的治疗方法较多，西医常见的有苯二氮卓类(BZD)抗焦虑药、三环类(TcAs)抗抑郁药等。中医治疗焦虑抑郁的关键在于以心为根本、以神为核心、以血为基础。本文从心、神、血的角度出发，阐述了心藏神，主血脉理论在焦虑抑郁中的重要性，并结合文献和临床研究结果，探讨基于“心藏神、主血脉”理论研究中医药治疗焦虑抑郁的作用机制以及临床应用思路，通过阐述理论的由来和内涵，从而分析其在焦虑抑郁诊治中的指导意义。

Abstract: Anxiety and depression is a common clinical mental illness. With the intense social competition and the increasing pressure of study, work and life, long-term anxiety and depression will have a great impact on personal life quality, physical and mental health, and even lead to suicide in serious cases. Traditional Chinese medicine believes that “heart storing spirit” is the core of the body’s physiological function, and it refers to the human mind activity. And “heart governing blood vessel” means that heart qi promotes and regulates blood flow in the pulse and plays the role of nourishing the whole body. The heart has the function of dominating all physiological activities and mental consciousness thinking activities, such as the five viscera and six organs. Traditional Chinese medicine has unique advantages in the treatment of anxiety and depression, and the use of traditional Chinese medicine compound, acupuncture and acupressure methods to treat anxiety and depression is remarkable. At present, there are many clinical treatment methods for anxiety and depression, and the common ones in Western medicine are benzodiazepines (BZD) anti-anxiety drugs and tricyclic (TcAs) anti-depressants. The key of TCM treatment of anxiety and depression is to take heart as the foundation, spirit as the core and blood as the basis. From the perspective of heart, spirit and blood, this paper expounds the importance of the theory of the heart storing spirit and governing blood vessel in anxiety and depression. Combined with the literature and clinical research results, this paper discusses the mechanism of action and clinical application of traditional Chinese medicine in the treatment of anxiety and depression based on the theory of “heart storing spirit and governing blood vessel” and expounds the origin and connotation of the theory, to analyze its guiding significance in the diagnosis and treatment of anxiety and depression.