基于黄元御“一气周流”理论论述老年抑郁症病机与治疗。认为老年抑郁症发生的核心病机为中土不运，木郁而生机抑遏，火衰而长令不遂，水亏而阳郁不达、神机失用，一气不得周流，发为抑郁诸症。治疗上以“一气周流”理论为指导，针对病机分别予培土升木、理气疏郁，益火扶土、升阳解郁，培土益肾、通阳达郁辨证治疗。提出临证遣方处药应以培调中土为基础，以达郁汤合逍遥散益脾而调木气，以黄芽汤合金鼎汤扶土益心降胃敛肺，以天魂汤扶中而益肾助阳，以地魄汤培土而敛神藏精。旨在通过培调中土，斡旋中气，枢转四旁，使一身之气血阴阳周流有序，升生长养之气畅达，气化精生复常，气血调畅，精神清明，以缓解诸抑郁症状，为老年抑郁症的中医药诊疗提供思路。

This article discusses the pathogenesis and treatment of geriatric depression based on HUANG Yuanyu's “One qi circulation” theory. It is believed that the core pathogenesis of geriatric depression is the failure of the central earth to transport,the depression of wood and the suppression of vitality,the decline of fire and the failure of long-term control,the deficiency of water and the depression of yang qi and the failure of the utilization of the spirit,which prevent the circulation of qi and lead to various symptoms of depression. In treatment,guided by the theory of “One qi circulation”,and in accordance with the pathogenesis,the earth is strengthened and wood is raised respectively to regulate qi and relieve depression. The fire is tonified to support the earth,yang qi is raised to relieve depression. The earth is cultivated to benefit the kidneys,yang qi circulation is promoted to dispel depression,and treatment is given based on syndrome differentiation. It is proposed that the prescription and treatment of medicine in clinical practice should be based on nourishing and regulating the central earth,so as to achieve the regulation of wood qi by the combination of Dayu Decoction（达郁 汤） and Xiaoyao Powder（逍 遥 散）. Huangya Decoction（黄芽汤） and Jinding Decoction（金鼎汤） are used to nourish the earth,benefit the heart,lower the stomach and consolidate the lungs. Tianhun Decoction（天 魂 汤） nourishes the middle to benefit the kidneys and boost yang qi,while Dipo Decoction（地魄汤） nourishes the earth to consolidate the spirit and store essence. The goal is to regulate the central earth,mediate the central qi,and coordinate the four sides,so as to make the circulation of qi,blood,yin and yang throughout the body orderly,promote the smooth flow of qi for growth and nourishment,restore the normal state of qi transformation and essence generation,regulate the smooth flow of qi and blood,and make the spirit clear,in order to alleviate various depressive symptoms and provide ideas for the diagnosis and treatment of geriatric depression with traditional Chinese medicine.