从“瘀毒郁互结”探讨急性心脑血管事件伴抑郁的病因病机

Discussion on etiology and pathogenesis of acute cardio-cerebrovascular events with depression based on“the combination of stasis-toxin-stagnation”

本文从字形、字义的角度分析了“瘀”“毒”“郁”的理论内涵,明确了其在“瘀毒郁互结”病机中的含义:“瘀”既指作为致病因素和病理产物的瘀血,又指急性心脑血管事件中的血瘀病机;“毒”主要指内生之毒,具有急骤性和暴戾性的特征,符合急性期的临床表现;“郁”主要包括病机层面的气机郁滞和疾病层面的忧郁病。本文在此基础上阐释了急性心脑血管事件伴抑郁的“瘀毒郁互结”病机。首先,瘀毒是急性心脑血管事件的病理机转;其次,忧郁熔冶于瘀毒病机的始终;最后,瘀毒是急性期忧郁卒然加重的根柢。文献计量分析发现,“瘀”是急性心脑血管事件和心脑血管事件伴抑郁的共同核心病机,“毒”是急性心脑血管事件的重要病机,“郁”是心脑血管事件伴抑郁的特征性病机。这项结果验证了“瘀毒郁互结”病机在急性心脑血管事件伴抑郁中的客观性及重要性,为临床研究提供了理论依据。

This research analyzes the theoretical connotation of"stasis,""toxin,"and"stagnation"based on their definition,and it clarifies their implication in"the combination of stasis-toxin-stagnation."Among them,"stasis"is not only a pathogenic factor and a pathological product,but it also refers to the pathogenesis of blood stasis in acute cardio-cerebrovascular events."Toxin"mainly refers to endogenous toxin,which has the characteristics of suddenness and severity,and these characteristics are consistent with the clinical manifestations in the acute phase."Stagnation"mainly includes stagnation of qi at the level of pathogenesis and depression at the level of disease.On this basis,our research also illustrates the pathogenesis of"the combination of stasis-toxin-stagnation"in acute cardio-cerebrovascular events with depression.First,stasis-toxin is the pathological basis of acute cardio-cerebrovascular events.Second,depression exists in the whole process of the pathogenesis of stasis-toxin.Finally,stasis-toxin is the root cause of the sudden aggravation of depression in the acute phase.Bibliometric analysis reveals that"stasis"is the common core pathogenesis element of acute cardio-cerebrovascular events and cardio-cerebrovascular events with depression."Toxin"is one ofthe most important pathogenesiselement of acute cardio-cerebrovascular events."Stagnation"is the key pathogenesis element of cardio-cerebrovascular events with depression.These results verify the objectivity and importance of the pathogenesis of"the combination of stasis-toxin-stagnation"in acute cardio-cerebrovascular events with depression and provide a theoretical basis for clinical research.