基于五运六气研究抑郁症患者抑郁相与狂躁相的发病规律

Occurrence Rule of Depressive Phase and Manic Phase in Depression Patients: Based on Five Movements and Six Climates

目的从五运六气探讨抑郁症抑郁相和狂躁相的发病规律,为抑郁症的病机认识和预防性治疗提供新思路。方法纳入抑郁症患者180例,其中重性抑郁74例、双相情感障碍106例,根据每次发病时间推算其总体抑郁症发作的主运、主气、客运、客气,得出发病时间与五运六气规律,以及发作为抑郁相和躁狂相的五运六气规律。结果 1)抑郁症总体发作的主运以火和金居多,土最少(P<0.01);客运以金、土居多,木最少(P<0.05);主气以阳明燥金最多,太阳寒水最少(P<0.01);客气未见明显不同(P>0.05)。2)总体抑郁相的发作主运以金运多而土运少(P<0.01),主气以阳明燥金高发而太阳寒水少发(P<0.01);躁狂相的主运高发在火(P<0.05),主气高发在少阴君火(P<0.05);总体抑郁相和躁狂相在主运和主气上的分布差异有统计学意义(P<0.05)。3)双相情感障碍的抑郁相主运集中在金运,而躁狂相集中在火运;抑郁相主气主要在阳明燥金,而躁狂相主要在少阴君火,二者都在太阳寒水呈现最低值;抑郁相和躁狂相的客气在太阴湿土、少阳相火上,抑郁相比躁狂相明显高发(P<0.01),双相情感障碍的抑郁相和躁狂相在客气上的分布差异有统计学意义(P<0.05)。结论抑郁症患者的发作具有明显的五运六气时间规律,抑郁症抑郁相和狂躁相的发作规律之间具有明显不同。

Objective To explore the occurrence rule of depressive phase and manic phase in depression based on the five movements of six climates,to provide new ideas for the understanding of pathogenesis and preventive treatment of depression. Methods A total of 180 cases of depression cases were included,of which 74 cases were major depression,106 cases were bipolar disorder. The dominant movement,the dominant climate,the guest movement and the guest climate were deduced according to each onset to obtain the occurrence rule between the time of onset and the five movements and six climates as well as the occurrence rule between the depressive phase,manic phase and the five movements and six climates. Results Firstly,the dominant movements of depression were mainly fire and gold,with the least earth（P 〈0. 01）; the guest movements were mainly metal and earth with the least wood（P 〈0. 05）; the dominant climate was mainly Yangming dry metal with the least Taiyang cold water（P 〈0. 01）; there was no obvious difference among guest climates（P 〈0. 05）. Secondly,the dominant movements of depression were most metal movement and least earth movement（P 〈0. 01）; the dominant climates were most Yangming dry metal and least Taiyang cold water（P 〈0. 01）; the dominant movement of manic phase was mainly fire（P 〈0. 05） while the dominant climate was mainly Shaoyin monarch fire（P 〈0. 05）; there was significant difference in the distribution of dominant movement and dominant climate between depressive phase and manic phase in general（P 〈0. 05）.Thirdly,the dominant movement of depressive phase in bipolar disorder was mainly gold,while the manic phase was mainly fire; the dominant climate of depressive phase was mainly Yangming dry metal,while that of manic phase was mainly Shaoyin monarch fire,both had the least Taiyang cold water; regarding the guest climates of both depressive phase and manic phase in Taiyin damp earth and Shaoyang ministerial fire,the depressive phase occurred significantly more frequently than the manic phase（P 〈0. 01）,and there was a significant difference in the guest climate in bipolar disorder between the depressive phase and the manic phase（P 〈0. 05）. Conclusion The onset of depression seems to have obvious rules in terms of the five movements and six climates,with different rules between the depressive phase and the manic phase.