Clinical Application of Liver-Spleen Theory in Depression Complicated with Spleen System Diseases

在中医理论中，抑郁症属“郁证”、“情志病”等范畴。调畅情志是肝非常重要的生理功能。七情为病，肝失疏泄是首发病机，肝郁脾虚是抑郁症发生发展过程中最关键的病理阶段。情志为病，多易伤肝，肝木易克脾土，常累及脾胃，出现呃逆、噎膈、反胃、呕吐、胃痞、腹痛、泄泻、便秘等脾系疾病。脾系疾病久而不愈，亦可加重抑郁症。在抑郁症的中医临床诊疗中，常以调理肝脾入手，在改善临床症状、减少抗抑郁药物不良反应、帮助减撤抗抑郁药等方面发挥积极作用。文章基于肝脾理论，分析抑郁症并脾系疾病的病理机制，总结名中医临床经验、中西医结合及现代中医药研究成果，对于发挥中医的独特优势、提高治疗抑郁症的临床疗效具有积极意义。In traditional Chinese medicine (TCM) theory, depression falls under the categories of “depression syndrome” and “emotional disorders.” Regulating emotions is a crucial physiological function of the liver. Liver depression and spleen deficiency are the most critical pathological stages in the onset and progression of depression. Emotional disturbances can easily harm the liver, and since the liver (wood) tends to overact on the spleen (earth), it often involves the spleen and stomach, leading to the system of spleen diseases such as hiccups, choking, nausea, vomiting, gastric discomfort, abdominal pain, diarrhea, and constipation. Chronic spleen disorders can also exacerbate depression. In the clinical diagnosis and treatment of depression in TCM, regulating the liver and spleen is often the primary approach. This method plays an active role in improving clinical symptoms, reducing the adverse effects of antidepressants, and aiding in the reduction of antidepressant dosage. Based on the theory of liver and spleen, this paper analyzes the pathological mechanisms of depression and spleen-related disorders, summarizes the clinical experiences of renowned TCM practitioners, the integrated research achievements of traditional Chinese and Western medicine, and the outcomes of modern traditional Chinese medicine research. This approach is of positive significance for leveraging the unique advantages of TCM and enhancing the clinical efficacy of depression treatment.