中医对焦虑障碍证候的经典名方治疗及其机理研究

Study on Treatment of Anxiety Disorders by Classical Chinese Medicine and Its Mechanism

中医学认为焦虑障碍相当于中医的脏躁病、郁证、卑惵病,其喜悲伤欲哭、倦怠、食欲不振等症状与焦虑障碍高度相似。论治焦虑障碍时,中医常用的经典名方主要面向焦虑障碍中的广泛性焦虑障碍(general anxiety disorder,GAD)、惊恐障碍(panic disorder,PD)两种分型,通过辨证论治,将GAD分为了痰郁热扰、血虚、肝气郁结、瘀热内阻、心肾不交5个证型,代表方为温胆汤,酸枣仁汤、逍遥散、血府逐瘀汤、黄连阿胶汤等方剂;将PD分为了肝失疏泄、心胆两虚2个证型,代表方为小柴胡汤、安神定惊汤等方剂。经研究,GAD中医证型里出现频率最高的是肝失疏泄证,用方逍遥散,PD中医证型中肝失疏泄、心胆两虚两证型出现频率相同,用方频率最高者为安神定惊汤、柴胡桂枝干姜汤。经典名方治疗GAD的平均治愈率达88%,治疗PD的治愈率达90%,治疗焦虑障碍平均显效时间约为35 d,综合考量,中医经典名方治疗焦虑障碍的理论基础可靠,临床疗效可靠,在实践中有研究意义。

In traditional Chinese medicine,anxiety disorders are considered to be equivalent to the disease named Zangzao,depression and Beidie disease in traditional Chinese medicine,with symptoms such as sadness and weeping,lethargy and loss of appetite being highly similar to those of anxiety disorders.In the treatment of anxiety disorders,the classical formulae commonly used in traditional Chinese medicine are mainly oriented towards the General Anxiety Disorder(GAD)and Panic Disorder(PD)subtypes of anxiety disorders,and the GAD is divided into five subtypes through the syndrome differentiation and treatment:phlegm depression and heat disturbance,blood deficiency,liver-Qi stagnation,internal obstruction of phlegm and blood stasis,and heart-kidney non-interaction.Through syndrome differentiation.The representative formulae included Wendan Decoction(温胆汤),Suanzaoren Decoction(酸枣仁汤),Xiaoyao Powder(逍遥散),Xuefu Zhuyu Decoction(血府逐瘀汤),Huanglian Ejiao Decoction(黄连阿胶汤).PD was divided into two types of symptoms:liver deficiency and deficiency of heart and gallbladder.The representative formulae included Xiaochaihu Decoction(小柴胡汤)and Anshen Dingjing Decoction(安神定惊汤).According to research,the most frequently occurring traditional Chinese medicine syndrome in GAD is liver failing to soothe syndrome,which is treated with Xiaoyao Powder.In PD,The same frequency is observed in liver failing to soothe syndrome and deficiency of heart and gallbladder syndrome.The most frequently used prescriptions are Anshen Dingjing Decoction and Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤).The average cure rate of classic Chinese medicine formulae for treating GAD is 88%and the cure rate for treating PD is 90%,and the average effective time for treating anxiety disorders is about 35 days.Based on comprehensive considerations,the theoretical basis and clinical efficacy of classic traditional Chinese medicine formulae for treating anxiety disorders are reliable,and they have research significance in practice.