中醫治療產後憂鬱症之用藥規律及特色分析

目的：本研究通過整理、分析《傅青主女科》中治療產後憂鬱症所用的方藥，以期闡述傅青主治療產後憂鬱症的用藥特點和配伍規律，並和現代中醫對於產後憂鬱症相關研究觀點結合。材料與方法：本文收集《傅青主女科》，依關鍵字搜索將所用中藥輸入Excel表格，進行頻數頻率統計，針對藥物功效、歸經的分布進行統計分析。結果：相關方藥共50味，總頻數為186次；功效分類前三名依序為補益藥、解表藥、祛溼藥。統計前12味高頻數，出現頻率佔了69.35%，使用前三名分別為當歸、川芎、甘草；統計前12味高頻數藥物歸經，最多為脾經，其次為肺經、胃經。結論：本研究顯示，傅氏認為產後憂鬱症病機以產後氣血大虧為重，跳脫傳統治療臨床憂鬱症之疏肝解鬱法，應注重產後婦女氣血虧損為主要辨證論治核心；從12味高頻藥物中發現，所包含的當歸、川芎、乾薑、桃仁，四味藥組合便是生化湯核心藥，方義基本與傅氏治療產後憂鬱症思路一致。常用藥物歸經主要為脾肺胃經，顯示傅氏於大補氣血時，同樣注重脾肺胃顧護，以恢復後天化生氣血功能。並將傅氏常用藥與現代藥理研究相結合，期許在臨床上能提供臨床醫師診治參考，提高中醫治療產後憂鬱症的療效，其相關藥理作用機轉仍有待中醫藥同道再進一步闡明。

關鍵字

傅青主女科；產後憂鬱症；方藥；用藥規律

並列摘要

Objective: To analyze and explore the characteristics of formulas used for the treatment of postpartum depression in Fu Qingzhu's Medical Department for Women. Also connect to modern Chinese medicine view in the postpartum depression. Materials and Methods: All formulas for postpartum depression from Fu Qingzhu's Medical Department for Women were imported into Microsoft Excel for statistical analysis, including the frequency, function and classification. Results: There are 50 Chinese medicine used in Fu Qingzhu's Medical Department for Women about postpartum depression. All of them were used up to 186 times. According to the function, the most frequently used Chinese medicine are tonics, followed by diaphoretics and diuresis. The top 12 high-frequency drugs accounted for 69.35% of the total number of occurrences, of which the top three were Angelica sinensis, Chuanxiong rhizome, and Licorice. 12 Chinese medicine of the highest frequency are classified as the the Spleen Meridian, followed by the Lung Meridian and Stomach Meridian. Conclusion: The pathogenesis of Fu Qingzhu's treatment of postpartum depression is mainly based on the great loss of Qi and blood after childbirth. In the treatment, the main purpose is to nourishing Qi and blood. The analysis of 12 high-frequency drugs reveals that the combination of the four herbs Angelica sinensis, Ligusticum striatum, Dried ginger and Peach kernel is Sheng Hua Tang. The formula is basically consistent with Fu's treatment of postpartum depression. The commonly used drugs are mainly classified as the Spleen, Lung, and Stomach meridians, showing that Fu Qingzhu pays attention to nourish the qi and blood, as well as Spleen, Lung, and Stomach Meridians. We hope this article.