从形神一体观论治抑郁障碍

Treatment of Depressive Disorder from the Perspective of the Concept of Holism

参照中医典籍及现代精神病学、心理学研究,结合临床诊治经验,从形神一体观出发,阐述抑郁障碍主要发病机制与治疗方法。其病以“情不遂、气不顺、脏虚实、闭户牖”四因而成,除情志之外,气机不畅是致病的中心环节,躯体疾病和久坐久卧亦是重要的致病因素,脏腑功能盛衰直接影响“五神”功能,多因错杂,最终形成以情绪低落、兴趣缺乏、意志活动减少为主要表现的临床症状。治疗当形神兼顾,遗方用药之外应注重认知行为治疗、正念干预等现代心理学技术的应用并结合体育锻炼,以“畅情志、理气机、平脏腑、活筋骨”四法并施,以求身心同调,形与神俱。

This paper expounds the main pathogenesis and treatment methods of depressive disorder from the perspective of the concept of holism,with reference to TCM classics and modern medicine psychiatry and psychological research,as well as clinical diagnosis and treatment experience.It is considered that the disease is caused by four causes,including"emotional failure,Qi obstruction,viscera deficiency and excess,and living alone".In addition to emotion,obstruction of Qi is the central link of the disease,and physical disease and sitting for a long time are also important pathogenic factors.The rise and fall of viscera state directly affects the function of the"Wu Shen",and finally forms clinical symptoms with depression and reduced will activity as the main manifestation.Therefore,in addition to the treatment of form and spirit,attention should be paid to the application of modern psychological techniques such as cognitive behavioral therapy,mindfulness intervention and physical exercise in the treatment,and the four methods of"unleashing emotion,regulating Qi,calming viscera,activating muscles and bones"should be carried out at the same time,in order to achieve physical and mental harmony,form and spirit.