围绝经期焦虑抑郁状态归属于中医学“脏躁”“绝经前后诸证”范畴。该文基于“阳化气，阴成形”理论，认为该病 病机复杂，多虚实兼见，与阳虚而郁、气郁神颓密切相关，可概括为阳虚为本，气郁为标，提出了“从阳论治”围绝经期 焦虑抑郁状态，采用“一针二灸三巩固”整合针灸阶梯方案：一针即针刺顺气为先，疏肝调神；二灸即精灸温阳开郁，通 阳运枢；三巩固即刺络祛瘀生新，埋针激阳理脏，共奏养心神、启神窍之效，以期改善围绝经期焦虑、抑郁症状，稳固 疗效。

Perimenopausal anxiety and depression state fall under the categories of “visceral agitation” and “perimenopausal syndrome” in traditional Chinese medicine （TCM） . Grounded in the theory of “Yang transforms qi，yin shapes form” ，this study posits that the pathogenesis of this condition is complex，often presenting with concurrent deficiency and excess syndromes，and is closely associated with yang deficiency-induced stagnation and qi stagnation leading to mental decline. The pathological mechanism is summarized as yang deficiency being the root and qi stagnation the manifestation. This article proposes a “yang-oriented treatment” approach for perimenopausal anxiety-depression disorders，employing a stepwise integrated acupuncture protocol termed “One Needling， Two Moxibustion， Three Consolidation”：“One Needling” prioritizes regulating qi flow via acupuncture to soothe the liver and harmonize the spirit； “Two Moxibustion” utilizes refined moxibustion to warm yang，resolve stagnation，and activate yang circulation； “Three Consolidation” combines bloodletting therapy to remove stasis and regenerate tissues with intradermal needle embedding to stimulate yang and regulate visceral functions. This synergistic protocol aims to nourish the heart-mind， awaken the orifices of consciousness，alleviate perimenopausal anxiety and depressive symptoms，and consolidate therapeutic efficacy.

R246.9

国家自然科学基金联合项目 （编号：U23A20507） ；广东省中医药局符文彬广东省名中医传承工作室资助项目 （粤中医办函 〔2020〕1号） ；广东省重点领域研发计划——岭南中医药现代化重点专项 （编号：2020B1111100007）