以爱感召,形神共调——运用“动-定序贯范氏八法”治疗糖尿病合并抑郁症1例
Inspired by Love, Professor FAN Assists Patients of Diabetes Combined with Depression to Achieve Physical and Emotional Harmony by "Variable-stable and Sequential Eight Methods"
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1.广东省中医院内分泌科,广州 510120
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何嘉莉, 唐咸玉, 范冠杰. 以爱感召,形神共调——运用“动-定序贯范氏八法”治疗糖尿病合并抑郁症1例[DB/OL].(2023-03-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601792&Fpath=home&index=0
HE Jiali, TANG Xianyu, FAN Guanjie. Inspired by Love, Professor FAN Assists Patients of Diabetes Combined with Depression to Achieve Physical and Emotional Harmony by "Variable-stable and Sequential Eight Methods"[DB/OL].(2023-03-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601792&Fpath=home&index=0
何嘉莉, 唐咸玉, 范冠杰. 以爱感召,形神共调——运用“动-定序贯范氏八法”治疗糖尿病合并抑郁症1例[DB/OL].(2023-03-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601792&Fpath=home&index=0 DOI:
HE Jiali, TANG Xianyu, FAN Guanjie. Inspired by Love, Professor FAN Assists Patients of Diabetes Combined with Depression to Achieve Physical and Emotional Harmony by "Variable-stable and Sequential Eight Methods"[DB/OL].(2023-03-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35601792&Fpath=home&index=0 DOI:
病史摘要,2,吕某,女性,56岁,2016年5月20日初诊。主诉:发现血糖升高5年,性情急躁易怒3年。现病史:缘患者5年前诊断为2型糖尿病,此后口服降糖药物治疗。3年前因生活事件刺激后出现情志异常,急躁易怒,失眠,诊断为抑郁症,曾服用左洛复治疗。此次诉受生活事件刺激,血糖控制不佳,性情急躁易怒,难以入眠,欲寻求中医治疗。刻下症:性情急躁易怒,口干口苦,大便秘结,睡眠欠佳,舌暗红,苔黄腻,脉弦略数。中医诊断 消渴(肝郁化火,湿热瘀阻);郁证(肝郁化火,湿热瘀阻)。西医诊断 2型糖尿病,抑郁症。干预措施 初诊:治疗措施:1.情绪疏导及生活方式宣教:鼓励患者多参与社交活动,增强治疗信心。适当减少食物摄入,每天晚餐后快走半小时至一小时,配合每日2 L中药汤剂少量频饮。中药煎煮方法:以4 L容量的药煲,加入3 L水,煎煮为2 L,代茶频饮。2.中医治法:清肝解郁,清热利湿,凉血活血。中药处方:柴胡5 g,白芍30 g,薄荷5 g(后下),牡丹皮15 g,白术30 g,生地黄30 g,连翘10 g,淡竹叶10 g,酒川牛膝15 g,益母草15 g,莪术10 g,丹参30 g,首乌藤15 g,甘草5 g。上方每日一剂,水煎温服。患者定期在范冠杰教授门诊随诊,调整中药。共服用中药120余剂。疗效转归 2016年10月16日患者复诊时性情趋于平和,睡眠改善,大便正常。抽血查空腹血糖6.4 mmol/L,糖化血红蛋白6.8%。
Summary of case history ,LV,female, 56 years old. Her first diagnosis time: May 20, 2016.Main complaint: blood sugar increased for 5 years and irritability for 3 years. History of Present Illness:The patient was diagnosed as "type 2 diabetes" 5 years ago, and was treated with oral hypoglycemic drugs. Three years ago, she was diagnosed with "depression" because of emotional abnormalities,irritability and insomnia after life events. She was once treated with Zoloft. Recently she was stimulated by life events, poor blood sugar control, irritable and difficult to sleep. She wanted to seek Traditional Chinese Medicine treatment.Symptom Impatient and irritable, dry mouth and bitter mouth, constipation, poor sleep, dark red tongue, yellow and greasy fur, slightly fast pulse string.,TCM diagnosis, Xiaoke (Pattern of depressed Liver Qi transforming into fire,dampness-heat and blood stasis), Yuzheng (Pattern of depressed Liver Qi transforming into fire, dampness-heat and blood stasis).,Western medicine diagnosis, type 2 diabetes,depression.,Therapeutic methods, 1.Emotional counseling and lifestyle education Professor Fan encouraged the patient to participate in social activities to enhance treatment confidence. In addition,he suggested that food intake should be reduced appropriately, and she should walk for half an hour to one hour after dinner every day, and drink a small amount of 2 liters of Chinese herbal decoction frequently.The method of decoction of traditional Chinese medicine: take a 4L medicine pot, add 3L water,decoct it into 2L and drink it frequently. 2.Chinese Medicine Chinese Medicine internal therapy clearing liver and relieving depression,clearing away heat and dampness,cool and invigorate blood. Chinese Medicine Prescription: Chaihu (Radix Bupleuri) 5 g、Baishao (Radix Paeoniae Alba) 30 g、Bohe (Herba Menthae) 5 g(later)、Mudanpi (Cortex Moutan) 15 g、Baizhu (Atractylodes macrocephala Koidz.) 30 g、Shengdihuang (Rehmanniae Radix) 30 g、Lianqiao (Forsythia suspensa) 10 g、Danzhuye (lophatherum herb) 10 g、,Jiuchuanniuxi (Wine Cyathulae Radix silce) 15 g、Yimucao (Herba Leonuri) 15 g、Ezhu (Curcumae Rhizoma) 10 g、Danshen (Salvia miltiorrhiza Bge.) 30 g、Shouwuteng (Caulis Polygoni Multiflori) 15 g、Gancao (Glycyrrhiza uralensis Fisch.) 5 g.One medicaments a day,decocted with water. She visited the outpatient clinic regularly, and Professor Fan adjusted her Chinese medicine plan.She totally took more than 120 doses of traditional Chinese medicine.,Clinical outcomes, On October 16, 2016, the patient tended to be calm, sleep improved, and her stool was normal. The fasting blood glucose was 6.4mmol/l and the glycated hemoglobin was 6.8%.
动-定序贯范氏八法糖尿病抑郁症
variable-stable and sequential eight methodsdiabetesdepreesion
范冠杰,魏华,唐咸玉,等.哲学中医——"动-定序贯范氏八法"与中医临床思维[M].北京:科学出版社,2020,3:20-27.
何嘉莉,范冠杰.运用"动-定序贯八法"防治糖尿病合并抑郁症的思路探讨[J].世界科学技术-中医药现代化,2018,20(4):501-504.
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