基于肺肾气虚理论治疗强迫症临证探讨

Clinical management of obsessive-compulsive disorder based on the theory of lung-kidney Qi deficiency

强迫症是一类以强迫观念和强迫行为为主要特征的精神障碍,其特点是有意识的强迫和反强迫并存。强迫症的临床表现、发生发展与五神脏中的肺魄、肾志密切相关,从肺藏气、气舍魄,肾藏精、精舍志,肺肾关系的生理基础等方面探讨肺肾生理相关性。强迫症病位在肺肾,肺肾气虚是其病因,肺虚魄扰、肾虚志弱是核心病机,补肺益肾为基本治法。在治疗上,以补肺敛魄、益肾强志为主,结合肺肾之苦欲补泻理论,兼顾肺喜收喜敛、肾喜闭藏的生理特性,应用酸味、苦味药物而施以相应的补法。结合临床病案,对基于肺肾苦欲补泻理论治疗强迫症进行介绍。

The obsessive-compulsive disorder is a type of mental disorder characterized by obsessive-compulsive concepts and compulsive behaviors.It is characterized by the coexistence of conscious compulsion and anti-compulsion.The clinical manifestations,occurrence and development of the obsessive-compulsive disorder are closely related to the lungs and kidneys in the five internal organs.The physiology of the lungs and kidneys is explored from the aspects of lung storage of Qi,Qi-shelving,kidneys storing essence,Jing housing the will,and from the physiological basis of the relationship between lungs and kidneys.The obsessive-compulsive disorder is located in the lungs and kidneys.Lung-kidney Qi deficiency is the cause of the disease.Lung deficiency and soul disturbance and kidney deficiency with a weak will are the core pathogenesis,and the basic treatment is to invigorate the lungs and kidneys.In terms of treatment,it focuses on invigorating the lungs and strengthening the spirit,strengthening the kidneys and strengthening the will.Under the guidance of the thoery that bitterness desires supplementation and purgation in the lungs and kidneys,and taking into account the physiological characteristics of the lungs and the kidneys,sour and bitter medicinals were used to supplemement.Combined with clinical cases,the treatment of obsessive-compulsive disorder is presented based on the theory bitterness desires supplementation and purgation in the lungs and kidneys.