慢性心力衰竭伴焦虑抑郁机理及中医药诊治特色与思考

Mechanism of chronic heart failure with anxiety and depression as well as characteristics and reflection of its diagnosis and treatment with traditional Chinese medicine

目前研究表明,在慢性心力衰竭(心衰)患者中,抑郁焦虑均有较高的发病率,并且与心血管事件发生风险、心衰再住院率及死亡率升高等不良结果密切相关。其主要机制可能在于二者生理病理联系和潜在的相互作用。试从中医“心主神明”及西医“双心医学”等相关理论出发,探求慢性心衰与抑郁焦虑的关系,通过回顾和整理目前中西医基于双心医学模式治疗心衰合并抑郁焦虑的方案和手段,深化对其发病机制的理解,探讨中医防治双心疾病的优势及不足,为中医药治疗双心疾病的发展提供参考。

Current research shows that there is high incidence of depression and anxiety in patients with chronic heart failure,which is closely related to adverse outcomes such as the risk of cardiovascular events,readmission rate for those with heart failure and increased mortality.The main mechanism may lie in their physiological and pathological relationship and potential interaction.The purpose of this paper is to explore the relationship between chronic heart failure and depression and anxiety based on related theories such as“heart controls the mental activity”in traditional Chinese medicine(TCM)and“cardiac-psychological medicine”in Western medicine(WM).By reviewing systematically the current TCM and WM schemes and means of treating heart failure combined with depression and anxiety based on cardiac-psychological medicine,we can deepen our understanding of its pathogenesis,explore the strengths and weaknesses of TCM in preventing and treating such diseases,thus laying a foundation for the further development of TCM diagnosis and treatment of cardiac-psychological diseases.