抑郁症"肝脾不调"病机探析OA

Depression is a mental disorder with high prevalence and recurrence rates,which falls within the"depression syndrome"category in traditional Chinese medicine(TCM).Based on the zang-fu TCM theory and integrating research progress in modern medicine,this paper elucidates the relationship between the liver and spleen in emotional regulation,analyzes the staged evolutionary characteristics of the pathogenesis of"liver and spleen imbalance"in depression,and reveals its biological mechanisms from the perspective of the neuro-endocrine-immune-energy metabolism network mediated by the brain-gut axis.This paper also clarifies the effects and mechanisms of harmonizing the liver and spleen.The liver and spleen synergistically regulate emotions under physiological conditions.Pathologically,the"liver and spleen imbalance"pathogenesis in depression presents a staged evolution:liver qi stagnation is the initiating factor,spleen qi deficiency is the key link in aggravating the condition,and liver-spleen imbalance leads to a protracted disease course,forming a vicious cycle of"liver qi stagnation-spleen qi deficiency-liver qi stagnation."Its biological mechanisms are primarily manifested as multi-system disorders,including neurotransmitter system dysregulation,intestinal microecological imbalance,immune-inflammatory responses,and metabolic abnormalities.Harmonizing the liver and spleen can exert antidepressant effects by regulating this multi-system network.In conclusion,the pathogenesis of"liver and spleen imbalance"in depression is a synergistic disorder of a multi-system network mediated by the brain-gut axis and a bidirectional dynamic evolutionary process between the liver and spleen.The primary therapeutic principles are soothing the liver,invigorating the spleen,as well as nourishing the liver.These principles align with the TCM concept of"treating diseases from the root cause"and the trend of multi-target intervention in modern medicine,thus providing theoretical support for the integrated treatment of depression.