精神创伤后应激障碍及其防治研究进展

Research progress on prevention and treatment of posttraumatic stress disorder

在我国,战争与现代社会精神创伤后应激障碍(PTSD)的研究是医学研究中一个相对薄弱的环节。本文从PTSD的症状、产生PTSD的原因、PTSD发生的生物学机制、PTSD的预防和药物治疗等四个方面综述了近年来国内外有关PTSD研究的状况。指出PTSD的发生与事件(战争、创伤)、个性特征和社会因素有关;其发病的神经生理机制与决定记忆、情绪、思维和社交的大脑或中枢神经系统密切相关;目前对PTSD是以心理治疗和靶症状药物疗法(主要采用抗抑郁和抗焦虑药物治疗)为主。未来对下丘脑-垂体-肾上腺轴、神经多肽、第二信使、细胞凋亡、基因表达等研究的理论,将为PTSD的发病机制提供新的神经生物学基础,也将为发展新型的抗PTSD药物提供重要的理论基础。加强对PTSD的基础和临床研究,是目前我国和我军医学领域面临的重要任务,具有军事和社会的双重意义。

In our country,the study of posttraumatic stress disorder(PTSD)in war and modern society is a relativelyweak link in medical research.In this paper,the research status of PTSD in recent years was reviewed from four aspects,includingthe symptoms,cause,biological mechanism,prevention and treatment of PTSD.We pointed out that the occurrence of PTSD wasassociated with the events of war and trauma,personality characteristics and social factors;the pathogenetic neurophysiologicalmechanism was closely related with the brain or central nervous system which governed the memory,emotion,thinking and socialcontact;the main treatment regimen of PTSD was psychological therapy and target symptoms therapy(mainly by antidepressantand anti-anxiety drugs).In the near future,the theory research of hypothalamic-pituitary-adrenal axis,neuropolypeptide,secondmessenger,cell apoptosis,gene expression and so on,will provide new neurobiological and theoretical basis for the pathogenesis ofPTSD and the development of new drugs in combat PTSD.Strengthening the basic and clinical research of PTSD is an importanttask in the medical field both for our country and army.