| 引用本文: |
曾凤婷, 杨虹, 夏庭伟.从“脑系-膜腠三焦”探讨抑郁症的病机与分期治疗[J].湖南中医药大学学报,2026,46(6):1171-1178[点击复制] |
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| 从“脑系-膜腠三焦”探讨抑郁症的病机与分期治疗 |
| 曾凤婷,杨虹,夏庭伟 |
| (成都中医药大学, 四川 成都 610075) |
| 摘要: |
| 抑郁症属中医学“郁证”范畴，其病机复杂，传统脏腑辨证难以全面阐释形神共病的病理特征。本文旨在突破传统肝、脾论治的固有框架，以陈潮祖教授的“膜腠三焦”理论为核心，结合“形神一体”的整体观，构建“脑系-膜腠三焦”体系。通过解析脑系筋膜与三焦膜腠的形质同源关系，揭示二者在元真输布中的协同作用：脑系为神机主宰，通过膜腠三焦的气液通道调控五脏气血；三焦壅滞则形伤及神，脑失濡养则神伤累形，形神互损形成抑郁的核心病机。针对“形神失调”的病机层次，提出三焦-脑系同治法则：初期以和解分消、透达膜腠，疏解气津郁滞；中期以开窍醒神、通络安神，恢复神机传导；后期以补气通元、形神和调，固本培元。以期为抑郁症治疗提供“调形复神”的创新辨治体系，为神志疾病的机制研究与临床实践提供新的中医思路。 |
| 关键词: 抑郁症 脑系-膜腠三焦 分期治疗 形神一体 元真通畅 |
| DOI：10.3969/j.issn.1674-070X.2026.06.011 |
| 投稿时间：2025-11-29 |
| 基金项目:国家自然科学基金项目（82405158）；成都中医药大学“杏林学者”学科人才科研提升计划（BSH2020013）；成都中医药大学基础医学院教育教学改革项目。 |
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| Pathogenesis and stage-based treatment of depression from the perspective of “brain system-membrane and interstices triple energizer” |
| ZENG Fengting, YANG Hong, XIA Tingwei |
| (Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China) |
| Abstract: |
| Depression is classified as "Yu Pattern" in Chinese medicine with intricate pathogenesis. Traditional pattern differentiation of zang-fu organs cannot fully elaborate the psychosomatic pathological characteristics of its concurrent body-spirit disorders. Breaking the conventional treatment framework focusing on the liver and spleen, this study constructs the "brain system-membrane and interstices triple energizer" framework based on Professor CHEN Chaozu's membrane and interstices triple energizer theory and the holistic TCM concept of body-spirit integration. By analyzing the homologous structural and functional relationship between brain fascia and triple energizer membranes and interstices, this paper expounds their synergistic effects in the transportation and distribution of primordial genuine qi. As the dominant organ governing mental activities, the brain system regulates qi and blood circulation of the five zang organs through the qi-fluid passageways of the triple energizer. Triple energizer stagnation induces physical lesion and subsequent spirit impairment, while insufficient cerebral nourishment leads to spirit damage that further injures the physical body. The mutual impairment of body and spirit constitutes the core pathogenesis of depression. Targeting the pathological hierarchy of body-spirit dysregulation, this study proposes a unified treatment principle for the triple energizer and brain system. In the early stage, the treatment focuses on reconciling and dissipating stagnation, unblocking membrane and interstices, and resolving qi and fluid stagnation. In the middle stage, it prioritizes opening orifices to awaken the spirit, unblocking collaterals and calming the mind to restore mental conduction function. In the late stage, it emphasizes tonifying qi and unblocking primordial genuine qi to harmonize body and spirit and consolidate the root of healthy qi. This study aims to establish an innovative TCM pattern differentiation and treatment system of "regulating the body to restore the spirit" for depression, and provide novel TCM ideas for the mechanistic research and clinical practice of mental disorders. |
| Key words: depression brain system-membrane and interstices triple energizer stage-based treatment body-spirit integration unobstructed primordial genuine qi |
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