冠心病、抑郁症与慢性应激
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摘要
慢性应激是机体受到持续刺激所产生的生理病理反应,临床可诱导抑郁症的产生。冠心病作为死亡率极高的心血管疾病,与抑郁症相互致病,且与慢性应激密切相关。从冠心病与抑郁症的发病机制以及两者的中医病因病机与慢性应激的关系进行阐述,并对冠心病与抑郁症的相互致病机理进行分析,认为慢性应激既是冠心病的重要致病条件,也是抑郁症发病的重要诱因;中医七情学说与应激理论类似,情志失调与冠心病、抑郁症的发病存在密切关联;冠心病与抑郁症互为病因,相互致病。
Chronic stress is a kind of physiological and pathological reaction in response to the persistent stimulation of body,it is an important induced factor of depression. Coronary heart disease is a cardiovascular disease with high clinical mortality; it is implicated in depression,and closely related to chronic stress. This article expounded the pathogenesis of coronary heart disease and depression,illustrated the relation of their etiology and pathogenesis in traditional Chinese medicine(TCM) to chronic stress,and analyzed their interactive pathogenicity mechanism. It is concluded that chronic stress is the major condition of coronary heart disease and depression; stress theory is similar to seven emotions theory in TCM,emotional maladjustment is implicated in coronary heart disease and depression; there exists a mutual cause-and-effect relationship between coronary heart disease and depression.
Chronic stress is a kind of physiological and pathological reaction in response to the persistent stimulation of body,it is an important induced factor of depression. Coronary heart disease is a cardiovascular disease with high clinical mortality; it is implicated in depression,and closely related to chronic stress. This article expounded the pathogenesis of coronary heart disease and depression,illustrated the relation of their etiology and pathogenesis in traditional Chinese medicine(TCM) to chronic stress,and analyzed their interactive pathogenicity mechanism. It is concluded that chronic stress is the major condition of coronary heart disease and depression; stress theory is similar to seven emotions theory in TCM,emotional maladjustment is implicated in coronary heart disease and depression; there exists a mutual cause-and-effect relationship between coronary heart disease and depression.
引文
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[2]Siegrist J,Sies H.Disturbed Redox Homeostasis in Oxidative Distress:a Molecular Link From Chronic Psychosocial Work Stress to Coronary Heart Disease?[J].Circulation Research,2017,121(2):103-105.
[3]徐航,陈焕新,王玮文.GABA能系统在应激诱发的抑郁症中的作用[J].心理科学进展,2017,25(12):2075-2081.
[4]Catalina-romero C.Depression and Cardiovascular Disease:Time for Clinical Trials[J].Atherosclerosis,2017,257:250-252.
[5]卢建敏,孙琳,黄彦生,等.抗抑郁治疗对不稳定心绞痛伴抑郁症的疗效分析[J].临床荟萃,2006,21(4):53.
[6]Siegrist J,Sies H.Disturbed Redox Homeostasis in Oxidative Distress:a Molecular Link From Chronic Psychosocial Work Stress to Coronary Heart Disease[J].Circulation Research,2017,121(2):103-105.
[7]赵益业.情志内伤与冠心病[J].现代中西医结合杂志,2004,13(15):1995-1996.
[8]王晓东,梁晨,吴振宇,等.慢性痒与抑郁交互恶化的机制[J].神经解剖学杂志,2017,33(2):241-246.
[9]刘燕,丁秀芳,严志祎,等.应激与胶质细胞功能的关系及中医药的调节作用[J].世界科学技术-中医药现代化,2017,19(9):1580-1585.
[10]谭尹娜,田绍文,侯立力.应激影响成体神经发生分子机制的研究进展[J].生理科学进展,2017,48(2):117-121.
[11]徐畅,周佳琦,卜舒扬,等.海马神经元再生与抑郁症[J].中风与神经疾病杂志,2016,33(11):1043-1044.
[12]周象贤,周萍.七情学说与应激理论之特征比较.医学与哲学[J].2001,22(6):49-50.
[13]孔伟华.肝主疏泄调畅情志文献综述[J].亚太传统医药,2016,12(17):52-53.
[14]严灿,邓中炎,吴伟康,等.从心理应激理论研究中医肝主疏泄藏象本质[J].中医杂志,2001,42(1):8.
[15]潘立文,王晓明.“肝为五脏之贼”的临床应用探析[J].中医药导报,2017,23(12):118-123.
[16]申力,曹洪欣.冠心病与情志变化相关研究[J].中国中医基础医学杂志,2016,22(11):1572-1573,1576.
[17]苏黎.冠心病与抑郁症之间关系的研究进展[J].临床医药文献电子杂志,2017,4(45):8904.
[18]石娟娟,沈莉,李鸿娜,等.解郁通脉汤治疗冠脉支架术后抑郁症68例临床观察[J].天津中医药,2016,33(3):139-143.
[19]王奇,戴小华.舒肝解郁胶囊治疗冠心病PCI术后焦虑抑郁症研究进展[J].中西医结合心脑血管病杂志,2017,15(7):820-822.
[20]Headrick JP,Peart JN,Budiono BP,et al.The Heartbreak of Depression:‘psycho-cardiac’Coupling in Myocardial Infarction[J].Journal of Molecular and Cellular Cardiology,2017,106:14-28.
[21]丁怀莹,王保和,徐强.冠心病合并抑郁症中医药研究现况[J].医学理论与实践,2017,30(3):332-334.
[22]徐敬海.冠心病支架术后并发抑郁症患者抗焦虑治疗的中西医疗效对照研究[J].中西医结合心血管病电子杂志,2016,33(18):71,74.