中医药拮抗创伤后应激障碍的研究现状
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摘要
创伤后应激障碍(PTSD)是由于遭受异乎寻常的威胁性或灾难性心理创伤,而诱发的长期持续的精神障碍。近年来,随着战争、自然灾害、严重交通意外、暴力犯罪等重大创伤意外的不断增多,PTSD的患病率逐年上升,引起了人们的高度关注。本文检索2006—2016年被中国知网(CNKI)收载的有关中医药拮抗PTSD的临床和实验性研究文献。从PTSD所属中医病证的范畴;中医对PTSD的病因病机的认识;PTSD的临床辨证分型与选方用药;中医药治疗PTSD的临床研究;针灸治疗PTSD的临床研究;中药拮抗PTSD的实验研究等6个方面对中医药拮抗PTSD的现状进行了综述。通过对检索的文献的整理与分析,多数学者将PTSD归属于中医百合病、嗜睡、心悸、不寐、健忘、厥证、郁证、奔豚气、梅核气等范畴;PTSD的中医临床辨证分型所涉及了心、肝、脾、肺与肾五脏,尤其是心、肝二脏;电针头穴治疗PTSD具有显著地临床疗效优势;中药复方拮抗PTSD的实验研究结果表明,海马区域的糖皮质激素受体(GR)与盐皮质激素受体(MR)受体的表达变化及调节HPA轴是中药复方拮抗PTSD的作用靶点或关键环节。对中医药拮抗创伤后应激障碍综合症研究中存在的问题进行了初步的分析。
In recent years,the prevalence of post-traumatic stress disorder( PTSD) has sharply increased because of the increasing major traumatic accidents,such as wars,natural disasters,traffic accidents and violent crimes. PTSD is a long-term persistent mental disorder that is caused by unusual threatening or catastrophic psychological trauma. Over the past decade,the incidence of PTSD has increased year by year,which causes high concerns from the public. This paper retrieved clinical and experimental literatures on treating antagonism of PTSD with traditional Chinese medicine( TCM) collected by CNKI from 2006 to 2016. It also overviewed the effect of TCM in antagonizing PTSD in the following six aspects: scope of TCM syndromes related to PTSD; understanding of etiology and pathogenesis of PTSD in TCM; clinical syndrome differentiation,prescription and medication for PTSD; clinical study on treating PTSD with TCM; clinical study on treating PTSD with acupuncture; experimental study of TCM in antagonizing PTSD. According to the summary and analysis of the retrieved literatures,most scholars classified PTSD into the following categories: Baihe disease, lethargy, palpitations, insomnia,forgetfulness,syncope syndrome,depression syndrome,up-rushing gas syndrome,globus hysteriocus. The clinical syndrome differentiation of PTSD involves heart,liver,spleen,lung and kidney,especially heart and liver.Electro-acupuncture at acupoints has a significant efficacy in the treatment of PTSD. The experimental results of antagonizing PTSD show that the changes in glucocorticoid receptor( GR) and mineralocorticoid receptor( MR) in hippocampus region receptor expression and the regulation of HPA axis are the targets or key links of TCM in antagonizing PTSD. The preliminary analysis was made on the problems in studies on the effect of TCM in antagonizing PTSD.
In recent years,the prevalence of post-traumatic stress disorder( PTSD) has sharply increased because of the increasing major traumatic accidents,such as wars,natural disasters,traffic accidents and violent crimes. PTSD is a long-term persistent mental disorder that is caused by unusual threatening or catastrophic psychological trauma. Over the past decade,the incidence of PTSD has increased year by year,which causes high concerns from the public. This paper retrieved clinical and experimental literatures on treating antagonism of PTSD with traditional Chinese medicine( TCM) collected by CNKI from 2006 to 2016. It also overviewed the effect of TCM in antagonizing PTSD in the following six aspects: scope of TCM syndromes related to PTSD; understanding of etiology and pathogenesis of PTSD in TCM; clinical syndrome differentiation,prescription and medication for PTSD; clinical study on treating PTSD with TCM; clinical study on treating PTSD with acupuncture; experimental study of TCM in antagonizing PTSD. According to the summary and analysis of the retrieved literatures,most scholars classified PTSD into the following categories: Baihe disease, lethargy, palpitations, insomnia,forgetfulness,syncope syndrome,depression syndrome,up-rushing gas syndrome,globus hysteriocus. The clinical syndrome differentiation of PTSD involves heart,liver,spleen,lung and kidney,especially heart and liver.Electro-acupuncture at acupoints has a significant efficacy in the treatment of PTSD. The experimental results of antagonizing PTSD show that the changes in glucocorticoid receptor( GR) and mineralocorticoid receptor( MR) in hippocampus region receptor expression and the regulation of HPA axis are the targets or key links of TCM in antagonizing PTSD. The preliminary analysis was made on the problems in studies on the effect of TCM in antagonizing PTSD.
引文
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[15]严灿,吴丽丽.基于“肾藏精,在志应恐”理论的创伤后应激障碍病机与防治研究思路探讨[J].环球中医药,2016,9(5):578-582.
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[17]杨敏,呼永河,郭明阳,等.髓海先天不足与创伤后应激障碍综合征之五脏传变[J].辽宁中医,2014,41(7):1369-1371.
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[19]罗长江,崔应珉.燮理阴阳——小柴胡汤的理论探讨与临床应用[J].光明中医,2016,31(24):3552-3554.
[20]万文蓉.张仲景小柴胡汤临床运用发微[J].中华中医药杂志,2013,28(1):124-127.
[21]高建伟,倪亚平.小柴胡汤证是治疗抑郁症的良方[J].实用中医内科杂志,2008,22(4):74-75.
[22]石映坤.逍遥散对焦虑抑郁障碍的疗效分析[J].世界最新医学信息文摘,2015,15(59):76-77.
[23]姜幼明,袁芳,姜跃进,等.逍遥散改善焦虑抑郁状态的临床研究概况[J].光明中医,2014,29(8):1802-1804.
[24]胡燕,洪敏.柴胡类方治疗抑郁症研究[J].中国实验方剂学杂志,2010,16(17):247-249.
[25]杨海英.逍遥散治疗郁证30例临床观察[J].内蒙古中医药,2010,29(9):68.
[26]王睿,王琪,金明顺,等.中药复方抗抑郁研究进展[J].中国中医基础医学杂志,2016,22(3):440-443.
[27]赵嫣虹,范薏淇,唐朝.百合地黄汤治疗抑郁研究进展[J].亚太传统医药,2016,12(15):79-81.
[28]李丽娜,高凌云.百合地黄汤加味治疗抑郁症34例[J].河南中医,2014,34(5):803-804.
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