从胆论治肿瘤相关性抑郁状态思路探析

Discussion on Treatment of Tumor-related Depressive State from the Perspective of Gallbladder

我国肿瘤的发病给社会和民众带来巨大的负担,肿瘤相关性抑郁状态患病率仍然较高。肿瘤相关性抑郁状态属中医“郁证”范畴,病郁同存是肿瘤患者常见状态。治疗患者的抑郁状态不仅可以改善情绪,还可以改善肿瘤相关预后。西医对此治疗存在局限性,中医药在身心同调方面发挥着独特优势。医者治病而弱于治心,因病致郁在病势和疾病转归的影响未得到足够的重视,从胆论治亦少有论述。笔者通过对中医典籍中有关胆、肿瘤、郁证的整理和查阅相关文献,发现胆在肿瘤相关性抑郁状态发展过程中是一个不可忽视的因素。本文从四个方面探析从胆论治肿瘤相关性抑郁状态:现代医学对肿瘤相关性抑郁状态的认识;中医对肿瘤相关性抑郁状态的认识;从胆论治理论基础;名医各家相关论治经验。旨在通过四个方面来阐释其科学的理论依据,以期对临床诊疗有所裨益。

The incidence of tumor brings great burden to society and people in our country,and the prevalence rate of tumor-associated depression is still high.Tumor-associated depressive state belongs to the category of“depression syndrome”in the field of traditional Chinese medicine(TCM),and the co-existence of disease(tumor)and depression is common for tumor patients.The relief of depression can not only improve the mood of patients,but also improve the tumor-related prognosis.Western medicine has limitations in the treatment of tumor-associated depression,but TCM has unique advantages in regulating both of the physique and the spirit.The influence of depression on the progression and the prognosis of the disease has not been given enough attention.The treatment from the perspective of gallbladder has been rarely discussed.In this article,the records associated with the gallbladder,tumor and depression in the TCM classical books were reviewed,and it is revealed that the gallbladder plays an important role in the progression of tumor-related depression.This paper discussed the treatment of tumor-associated depressive state from four aspects:the understanding of tumor-associated depressive states in western medicine;the understanding of tumor-associated depressive states in traditional Chinese medicine;the theoretical basis of treatment from the perspective of gallbladder;the relevant treatment experience of various famous practitioners.The discussion on the scientific theoretical basis of treatment from the perspective of gallbladder will be beneficial to the clinical treatment of tumor-associated depressive state.