摘要：历代医家多认为围绝经期抑郁症为女子天癸不足，肾气虚弱，肝肾同源，肾虚肝郁，多从脏腑辨证，而处方用法多以疏肝理气为主。吴林教授认为更年期抑郁症患者，初期使用疏肝解郁之法，可初期短期取得疗效，但在后期患者会因肝气疏泄太过而出现不寐加重，甚至烦躁不安等症状加重的问题。吴林教授经过长期的临床实践，认为围绝经期抑郁症有其性别的特异性，可从气血辨证论治本病，女子以血为本，气能生血，血能养气，步入中老年月水逐渐枯竭，阳气亦随之衰减，阳衰神颓，心神不宁，气血亏虚或气滞血瘀为加重本病的重要病因。故此病可从气血辨证，以补血行气、活血化瘀等为治疗原则，为治疗本病提供新的治疗思路。

    关键词：围绝经期抑郁症；气血辨证；归脾汤加减

    中图分类号：R255.9

    文献标志码：A

    文章编号：1007-2349(2024)10-0011-04

    Treating Perimenopausal Depression from the Perspective of Qi and Blood

    CHEN Yuan-liang¹， ZHU Jian-min¹， CHEN Wei²， ZHANG Jin-zhi¹ WU Lin¹

    (1. Guangxi University of Traditional Chinese Medicine， Nanning 530001， China;

    2. The First Affiliated Hospital， Guangxi University of Traditional Chinese Medicine， Nanning 530001， China)

    【Abstract】Historically， physicians have attributed perimenopausal depression to a deficiency of "Tian Gui" (heavenly essence) in women， resulting in qi deficiency of kidney and liver due to the interconnectedness of the liver and kidney. Traditional diagnosis has been based on organ pattern differentiation ......