基于情志致病理论从气机升降论述双相情感障碍的病机及治疗

Pathogenesis and Treatment of Bipolar Disorder Based on the Theory of Emotional Pathogenicity and Ascending and Descending of Qi Movement

双相情感障碍属中医情志病范畴,是精神科常见重性精神疾病,当前其中医辨证思路较少、尚未达成统一。气机是人生命活动的基本形式,气机升降相因是维系机体气、血、津液、精等精微物质生成、输布,进而实现人体“阴平阳秘”的关键条件。情志过激则易致气机紊乱、脏腑失和,进而诱发情志病。故本文以气机升降运动失司为疾病发生发展之纽带,邪气盛衰为疾病转化之关键,脾胃受损为疾病复发之基石,动态阐释双相情感障碍的病机演变;并提出临床治疗需重视药物药性,善用针灸、中医情志疗法等中医传统疗法形神同调、心身同治等建议;以期为临床工作者治疗双相情感障碍提供新的治疗思路,并为从气机升降理论运用中医药防治双相情感障碍提供理论依据。

Bipolar disorder belongs to the category of emotional diseases in traditional Chinese medicine(TCM)and is a common serious mental disease in psychiatry.At present,the ideas of TCM syndrome differentiation of dipolar disorder are deficient and have not been unified.Qi movement is the basic form of human life activities,and ascending and descending of qi movement can maintain the generation and distribution of qi,blood,body fluid,essence,and other fine substances of the body,which can achieve“peaceful yin and compact yang”of the human body.Emotional overreaction can easily cause qi disorder and zang-fu disharmony,and then induce emotional diseases.Therefore,the present study dynamically explained the pathogenesis evolution of bipolar disorder with dysfunction in the ascending and descending of qi movement as the link of disease occurrence and development,exuberance and debilitation of pathogenic qi as the key to disease transformation,and the damage of spleen and stomach as the cornerstone of disease recurrence.In clinical treatment,it was suggested to attach importance to drug properties and to make good use of TCM therapies such as acupuncture and moxibustion,emotional therapies of TCM,and so on,aiming to provide a new treatment idea for clinical workers to treat bipolar disorder and a theoretical basis for the prevention and treatment of bipolar disorder by TCM from the theory of qi movement.