刘新春对青中年广泛性焦虑症病机认识及治疗

LIU Xinchun’s Understanding and Treatment of Pathogenesis of General Anxiety Disorder in Young and Middle-aged

随着生活节奏的加快,来自工作、学习、生活等多方面的压力使得焦虑情绪产生增多,导致广泛性焦虑症的发病人数上升。广泛性焦虑症是一种心身疾病,除精神症状外,常累及神经、呼吸、消化、循环等多个系统,临床症状复杂。西药治疗本病虽疗效确切,起效快,但存在成瘾性、耐药性、药物靶点单一、不良反应多、患者依从性差等弊端。相较而言,中药复方具有多成分、多靶点、临床疗效好、不良反应少的优势,能针对个体差异在辨证论治的基础上治疗,更具有独特优势。刘新春主任认为情志不遂、忧思过度,气机郁滞,肝气郁结,脾胃失和,日久致痰、瘀、火内蕴,内扰心神,心神不宁而情志为病是青中年广泛性焦虑症的主要病机。临床治疗时主张以疏肝理气、和调脾胃为基本治疗方法,佐以安神定志,视病情兼以化痰、行瘀、清火,配合心理疗法,多法并用,整体调治。柴胡疏肝散和温胆汤为中医经典方剂,刘新春主任在此基础上加减出自拟方,临床治疗青中年广泛性焦虑症疗效满意,并附上典型病案2例,以期为本病的临床防治提供一定思路和方法。

With the acceleration of life rhythm as well as the pressure from work,study,life and other aspects,the anxietyhas been increased and there is an increase in the number of people with generalized anxiety disorder. Generalized anxiety disorder is a psychosomatic disease. In addition to mental symptoms,it often involves multiple systems such as nerves,breathing,digestionand circulation. The clinical symptoms are complex. Although Western medicine has a definite curative effect and rapid onset of the disease,there are drawbacks such as addiction,drug resistance,single drug target,multiple adverse reactionsand poor patient compliance. In comparison,traditional Chinese medicine compound has the advantages of multiple ingredients,multiple targets,good clinical efficacyand few adverse reactions. It can be treated on the basis of syndrome differentiation and treatment for individual differences. Director LIU Xinchun believes that emotional distress,excessive worry,stagnation of Qi,liver Qi depression,disharmony between spleen and stomach,phlegm,blood stasis and internal firedisturbing the mind,the restless mindare the main pathogenesis of generalized anxiety disorder for the young and middle-aged. In clinical treatment,it is recommended to soothe liver and regulate Qi and adjust the spleen and stomach as the basic treatment method,supplemented with calming the mind,combined with resolving phlegm,eliminating blood stasisand clearing fire methods and psychological therapy. Multiple methods are used together. Chaihu Shugan Powder and Wendan Decoction are classic prescriptions of traditional Chinese medicine. Director LIU Xinchun added or subtracted the self-made prescription on this basis. The clinical treatment of young and middle-aged patients with generalized anxiety disorder is satisfactory,and 2 typical cases were attached to provide some ideas and methods for clinical prevention and treatment.