摘要
郁证(焦虑、抑郁)作为典型的心理疾病,常与冠状动脉粥样硬化性心脏病(CHD)兼而并见、互为影响,构成心之血脉与心之神志共病的双心疾病。基于“病郁同存”理论,提出CHD与郁证既独立存在,又因果关联。郁之因素贯穿于CHD的始终,在不同阶段具有不同的因果关系,存在“因郁致病”或“因病致郁”的病机演绎。慢性隐匿期以痰为重,因郁生痰,痰结气阻,启动双心互损进程,为疾病之肇端;病理发展期以瘀为主,因郁致瘀,瘀阻气滞,加速疾病恶化进展,为疾病之机转;急性发作期以毒为要,因郁化毒,毒损气血,扰动神机,诱导病情急剧骤发,为疾病之遽变。据此确立痰郁同治、瘀郁同治、毒郁同治的分阶段“病郁同治”法,研究发现该治法可同步改善器质损伤与情志障碍,并具有反映于微观的证候指标调节作用,从而实现双心同调、形神共治之效。
Depression syndromes(anxiety and depression),as typical psychological disorders,often coexist with and mutually influence coronary heart disease(CHD).They constitute a psycho-cardiology disease involving both the blood vessels of the heart and the spirit of the heart.Based on the theory of "coexistence of diseases and depression syndromes",it was proposed that CHD and depression syndromes coexisted independently and were causally related.The factors of depression syndromes go through the entire course of CHD and have different causal relationships at different stages,leading to a pathogenic process of "depression causing disease" or "disease causing depression".In the chronic latent period,phlegm predominates,with depression leading to the production of phlegm.Phlegm accumulation and Qi stagnation initiate a mutual damage process of psycho-cardiology,marking the onset of the disease.In the pathological development period,blood stasis becomes predominant.Depression leads to blood stasis,which further obstructs Qi circulation,accelerating disease progression.In the acute attack period,toxicity becomes crucial.Depression transforms into toxicity,damaging Qi and blood,disturbing the balance of the mind,and inducing a sudden and severe exacerbation of the disease.Based on this,the approach of treating phlegm and depression together,treating blood stasis and depression together,and treating toxicity and depression together by stages was established.Research has found that this approach can simultaneously improve organic damage and emotional disorders,and also has a regulating effect on micro-level syndrome indicators,achieving harmonization of psycho-cardiology in the treatment.
作者
钟森杰
高翔
王卢曦
陈洁
吴辉
李静
方红城
冼绍祥
ZHONG Sen-jie;GAO Xiang;WANG Lu-xi;CHEN Jie;WU Hui;LI Jing;FANG Hong-cheng;XIAN Shao-xiang(the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Postdoctoral Research Station of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,China;Diagnosis Institute of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine,Shenzhen 518104,China)
出处
《中国中药杂志》
CAS
CSCD
北大核心
2023年第20期5675-5680,共6页
China Journal of Chinese Materia Medica
基金
国家中医临床研究基地建设项目(国中医药科技函[2018]131号)
冼绍祥岐黄学者工作室
广州市校(院)联合资助项目基础与应用基础研究项目(202201020342)
广州市科技局2022年重点研发项目(2060404)
深圳市“医疗卫生三名工程项目”(SZZYSM202106006)。
关键词
冠状动脉粥样硬化性心脏病
郁证
痰浊
血瘀
毒邪
双心医学
coronary heart disease
depression syndrome
phlegm turbidity
blood stasis
toxic pathogen
psycho-cardiology medicine
