宋敏 左政 李亚楠 吴婧 代殴

摘要 中风后抑郁症（PSD）是中风患者常见的并发症之一，患者精神神智受到一定程度的损害，并且严重影响着患者的治疗。以PSD患者作为研究对象，分别从中、西医角度探讨其病因病机及治疗方法。查阅近10年中医学与现代医学有关PSD的相关文献，归纳病因病机及中西医治疗现状，分析结果表明中西医治疗PSD方法较多，且均有不同程度的疗效。目前临床上无论是中医学的治疗方法还是现代医学的治疗方案，均可以改善患者的抑郁程度，利于患者神经功能的恢复及日常生活能力的提高。

关键词 抑郁症;病因病机;针灸治療;中药治疗;艾灸治疗;药物治疗;心理治疗;综述

Abstract Post-stroke depression（PSD）is one of the common complications of stroke patients.The mental state of patients is damaged to certain extents，which seriously affects the treatment progress of the patients.This paper takes PSD as the object of study to explore its etiology，pathogenesis and treatment from the perspectives of traditional Chinese and western medicine.The relevant literature on PSD in traditional medicine and modern medicine in the past 10 years were reviewed and summarized from etiology and pathogenesis to the current situation of traditional Chinese and Western medicine treatment.The study shows that there are many kinds of traditional Chinese and Western medicine in the treatment of PSD with different degrees of curative effect.At present，both the treatment methods of traditional medicine and modern medicine can improve the degree of depression，facilitate the recovery of neurological function and improve the ability of daily life of patients.

Keywords Depression; Etiology and pathogenesis; Acupuncture treatment; Traditional Chinese medicine treatment; Moxibustion treatment; Drug therapy; Psychotherapy; Review

中图分类号：R255.2;R277.7文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.028

中风后抑郁症（Post-stroke Depression，PSD）是中风后患者最常见的并发症之一，表现为精神萎靡不振，生活不能自理，心理情绪低落等，影响患者的神经功能、认知功能的恢复，给家庭和社会亦造成一定的经济负担。所以对于中风后抑郁症患者的康复治疗尤为重要。现将PSD病因病机及各种治疗方法综述如下。

1 病因病机

1.1 中医学病因病机 PSD虽在中医学上没有这一病名的体现，但其属于“中风”之后变证的范畴，也是“中风”和“郁证”的合病。PSD发生在中风之后，既具备中风的临床特点，又具有抑郁的临床症状。韩宁[1]认为本病病位在脑，病因病机有标本2个方面，致病之本为肾精亏虚、脏腑功能失调，致病之标是肝郁气滞、血脉瘀阻，临床症状主要表现为精神情志的改变。……