周丹 顾志坚 朱蕾蕾

    [摘要] 本文通过验案介绍蒋健教授关于“郁证脾胃病”的临床经验及其学术观点。郁证性脾胃病的临床特征为：脾胃病类症状因情志致病因素引起，并兼有情志类、脾胃病类以及脾胃病以外纷繁多彩的躯体表现；无器质性胃肠疾病或以其不能合理解释患者症状；症状怪异不合常理；从郁论治或辅助从郁论治有效。郁证性脾胃病的治疗需遵从四个原则：从郁论治药物疗法和情志疗法相结合；解郁治本与郁证脏腑定位结合；从郁辨证论治与辨证论治相结合；从郁论治与从痰论治、从瘀论治相结合。郁证性脾胃病以郁证为本、脾胃病类表现为标，故从郁论治为治其本，针对脾胃病类症状的治疗为治其标。

    [关键词] 郁证；脾胃病；诊断；从郁论治；怪症多郁

    [中图分类号] R256.3 [文献标识码] A [文章编号] 1673-7210(2018)08(c)-0129-04

    [Abstract] This paper introduces Professor Jiang Jian's clinical experience and academic views on “spleen and stomach disease due to depression syndrome” through experienced cases. The clinical features of spleen and stomach disease due to depression syndrome are as followed： the symptoms of spleen and stomach disease are caused by emotional pathogenic factors， and there are various physical manifestations of emotion， spleen and stomach disease， and beyond spleen and stomach disease； there are no organic gastrointestinal disease or it can not properly explain the patients' symptoms； the symptoms are strange and irrational； it is effective by treatment from depression or by adjuvant treatment from depression. The treatment of spleen-stomach disease due to depression syndrome need follow four principles： the treatment of disease from depression needs combination of medication and non-pharmaceutical approaches； radical treatment for resolving depression need combination with zang-fu location； the treatment of disease from depression needs combination with syndrome differentiation； the treatment of disease from depression needs combination with treatment from phlegm and stasis. The treatment of spleen-stomach disease due to depression syndrome takes depression as root cause and symptom of spleen and stomach disease as manifestation ......