从《内经》“五神脏”角度浅析心与经前焦虑性障碍的相关性

Discussion on Correlation between Heart and Premenstrual Dysphoric Disorder from the Theory of "Wushenzang" of Neijing

经前焦虑性障碍(Premenstrual dysphoric disorder,PMDD)是在月经周期的黄体后期表现出的一系列情绪和情感方面的不适症状。西医对该病的发病机制尚未明确,治疗效果不佳。本病属于中医"月经前诸症"的范畴,多数学者认为"肝郁"是本病的病因病机,治疗多从"肝"论治。但从《内经》"五神脏"的角度分析,心为五脏之主,心神为五神之主,虽然五志舍于五脏,但任何情志的异常变化都会首先伤及心神,进而影响到相应的脏腑;同时,"心主血脉",血为各种神志活动的主要物质基础。故经前期焦虑性障碍所表现出的情绪、情感方面的异常症状与"心"的关系最为密切。

Premenstrual dysphoric disorder（PMDD） is a severe form of premenstrual disorder occuring during the late luteal phase, which causes clinically relevant functional impairment. But why it comes and how to treat it is still uncertain as yet. While from the view of traditional Chinese medicine, it may belong to ＂the syndromes before the menstrual cycle＂, and it is widely accepted that PMDD is due to liver stagnation, and should be treated from the liver. However, based on the theory of ＂Wushenzang＂ of Neijing, it is the heart that governs other organs and the emotion, so it hurts the heart before it causes influence on other viscera when unwonted emotions occurs. Moreover, heart governing blood and vessels, which provides substance basis of mental activity. In all, it is certain that PMDD has a strong connection with heart.