中医药治疗双相情感障碍研究进展

Treatment of Bipolar Disorder with Traditional Chinese Medicine: A Review

双相情感障碍(Bipolar disorder,BD)是一种复杂精神疾病,以躁狂或轻躁狂发作与抑郁发作循环、交替、反复出现为症状表现,具有高度异质性临床表现和病理学特征。现有以心境稳定剂及抗精神药物为主的药理学及非药理学治疗方式效果欠佳且副作用多。以整体观念、辨证论治为特点的中医疗法,恰契合因机体复杂性而引发疾病本质,在BD防治方面具备独特优势。本文总结归纳了BD的中医学认识、中医辨证分型、中医药治疗BD的内治法与外治法应用,详细阐述了中医药辨证论治的病因病机、治法治则、方药配伍,总结了情志护理、针灸疗法、八段锦、耳穴贴压、拔罐等多种特色疗法,发现中医药治疗BD均可获得良好效果,且不良反应率低。同时探讨了目前中医药治疗BD存在的弊端及不足,促使中医药治疗更加科学化、严谨化、多样化,为中医药临床提供更多选择,为更好地继承与发扬中医药传统文化奠定基础。

Bipolar disorder is a complex psychiatric disorder with a highly heterogeneous clinical and pathological profile,characterized by cyclic,alternating and recurrent manic or hypomanic episodes and depressive episodes.The existing pharmacological and non-pharmacological treatments based on mood stabilizers and antipsychotics have poor effects and many side effects.Traditional Chinese medicine(TCM)therapy,which is characterized by holistic concept and syndrome differentiation and treatment,just fits the nature of diseases caused by the complexity of the body,and has unique advantages in the prevention and treatment of bipolar disorder.This paper summarizes the TCM understanding of bipolar disorder,the classification of TCM,the internal and external treatment methods of TCM for bipolar disorder,and details the etiology,treatment rules,prescriptions and medicines of TCM,and summarizes a variety of characteristic therapies such as emotional and spiritual care,acupuncture therapy,Baduanjin,auricular pressure and cupping.At the same time,this paper discussed the disadvantages and shortcomings of the current treatment of bipolar disorder with TCM,which makes the treatment of TCM more scientific,rigorous and diversified,provided more choices for the clinic of TCM,and laid the foundation for better inheriting and developing the TCM culture.