从心肝脾论治腹泻型肠易激综合征伴焦虑或抑郁状态

Treatment of diarrhea irritable bowel syndrome with anxiety or depression from the TCM theory of heart,liver and spleen

焦虑和抑郁等精神心理异常不仅是诱发肠易激综合征(IBS)的重要因素,同时是IBS最常合并的病理状态,可加重患者肠道症状,引起躯体症状障碍,增加治疗难度,影响药物疗效,给患者造成巨大身心负担,降低生活质量。近年来,中医药治疗腹泻型肠易激综合征(IBS-D)注重中医心功能失调对IBS肠道功能和精神心理的影响,并逐渐从肝脾论治发展到从心肝脾论治的新阶段。文章围绕焦虑和抑郁对IBS-D发生发展和治疗的影响,以中医心肝脾功能异常与IBS-D伴焦虑或抑郁的联系为纽带,重点阐述了从心肝脾论治的思路和方法,强调从肝脾论治以改善肠道症状是基础,从心脾和心肝论治精神心理症状是主要手段,两者同步治疗可提高疗效。

Mental and psychological disorders such as anxiety and depression are not only important factors to induce irritable bowel syndrome(IBS),but also the most common pathological state of IBS,which can aggravate the patients’intestinal symptoms,cause physical symptom disorder,increase the difficulty of treatment,affect the curative effect,and cause huge physical and mental burden to the patients,as well as reduce the quality of life.In recent years,traditional Chinese medicine(TCM)treatment of IBS-D has focused on the influence of heart dysfunction of TCM on intestinal function and mental psychology of IBS,and gradually developed from the treatment of liver and spleen to a new stage of treatment of heart,liver and spleen.This article focused on the influence of anxiety and depression on the development and treatment of IBS-D.Based on the link between dysfunction of heart,liver and spleen and IBS-D with anxiety or depression,it focused on the idea and method of treatment from the heart,liver and spleen,and emphasized that treating the liver and spleen to improve intestinal symptoms was the basis.Concurrently,the paper expounded treating mental and psychological symptoms from heart and liver was the main method,while the comprehensive treatment of both could significantly improve the curative effect.