中医辨证论治双相情感障碍的治疗现状与展望

Treatment Status and Prospect of BD Based on Syndrome Differentiation

双相情感障碍(BD)又称躁郁症,是一种临床常见的间歇发作性心境障碍,特征是抑郁伴有躁狂或轻躁狂发作,是导致青年残疾的主要原因之一,给社会带来沉重的经济负担。目前BD发病机制不明,西医学治疗方式以精神药物内服为主,存在疗效不佳、反复发作和不良反应较多等缺陷,而中医药具有多靶点、多系统、整体调节且安全性高的优势,一定程度上能弥补西医学治疗的不足。本文从病位、临床症状、病因病机和病程演变等角度阐明了BD与中医学“癫狂”的相似性,认为BD属于“癫狂”的表现形式之一,并按照辨证分型归纳了BD的治则治法、治疗机制和名医经验,同时探讨了当前中医药研究和治疗BD的不足之处,旨在为中医药防治BD提供参考和思路。

Bipolar disorder(BD),also known as manic-depressive psychosis,is a common clinical episodic mood disorder,characterized by depression accompanied by manic or hypomania episodes,is one of the main causes of disability in young people,bringing heavy economic burden to the society.At present,the pathogenesis of BD is unknown,and the modern medical treatment is mainly based on psychotropic drugs,which has defects of poor efficacy,repeated attacks and many adverse reactions.However,TCM has the advantages of multi-target,multi-system,holistic regulation and high safety,which can make up for the disadvantages of modern medical treatment to some extent.This study illuminated the similarity between BD and Dian Kuang(manic-depressive psychosis)in terms of disease location,clinical symptoms,etiology and pathogenesis and course of disease evolution.It regarded that BD belonged to one of the forms of Dian Kuang,summarized therapeutic principle of BD according to syndrome differentiation,treatment mechanism and doctors experiences,and discussed shortcomings of the current TCM researches in treatment of BD,aiming to provide reference and ideas for preventing and treating BD with TCM therapies.