从“神”探讨精神分裂症的三大主症

Exploration on the three main symptoms of schizophrenia from the perspective of“spirit”and descending

精神分裂症属中医“癫狂”范畴,其阴性症状、阳性症状分别与中医癫证、狂证临床表现基本一致。其中阳性症状主要表现为思维障碍、妄想、幻觉等;阴性症状主要表现为情绪低落、反应迟钝、思维言语贫乏、情感淡漠等;认知损伤包括注意力难以集中、执行力差和工作记忆障碍等。这三大主症与中医“神”密切相关。其中魂为阳神,阳主升发,阳神易亢,可表现为阳性症状;魄为阴神,阴主敛降,阴神易敛可表现为阴性症状;神机出入失常,神机失用则表现认知损害。据此对从升降出入辨治精神分裂症进行探讨。

Schizophrenia belongs to the category of“manic depressive psychosis”in traditional Chinese medicine,and its negative and positive symptoms are basically consistent with the clinical manifestations of epilepsy and mania of traditional Chinese medicine.Among them,the positive symptoms are mainly manifested as thinking disorders,delusions,hallucinations,etc.,and the negative symptoms are mainly manifested as depression,slow response,poor thinking and speech,emotional indifference,etc.,while the cognitive impairment includes the difficulty in concentrating,poor executive ability,and working memory disorders,etc.These three main symptoms are closely related to the notion of spirit of traditional Chinese medicine.Among them,the soul is the yang spirit and yang governs ascending and dredging,while the yang spirit tends to become hyperactive,resulting in the positive symptoms.The inferior spirit is the yin spirit,and yin governs converging and descending,while the yin spirit tends to converge,resulting in the negative symptoms.The abnormal access to the spirit may lead to the poor performance of mental activities,manifested as the cognitive impairment.Based on the above discussion,the differentiation and treatment of schizophrenia are explored in the paper from the perspective of the spirit’s ascending,descending and access conditions.