中医规范化辨证论治双相情感障碍的策略  

Strategies of Traditional Chinese Medicine Standardized Treatment Based on Syndrome Differentiation of Bipolar Disorder

作　　者：俞赟丰 周曼丽 罗小欣 赵彦禛 简维雄 YU Yunfeng;ZHOU Manli;LUO Xiaoxin;ZHAO Yanzhen;JIAN Weixiong(College of Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208 [2]湖南中医药大学第一附属医院,长沙410007

出　　处：《中国实验方剂学杂志》2023年第21期180-187,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81973753)。

摘　　要：双相情感障碍(BD)是一种具有高自杀率的严重慢性情绪障碍,是常见的精神科疾病。中医药辨治BD具有独特的优势和良好的安全性,有望成为治疗的新突破口。该文在尹冬青教授和贾竑晓教授《双相情感障碍中医证候辨证分型标准专家共识》的基础上,根据数据库的现有文献荟萃BD各类证型的治疗方案,并根据美国卫生保健质量和研究机构(AHRQ)颁布的证据评价标准评估证据等级。(1)抑郁发作。①肝郁脾虚证:逍遥散丸或舒肝解郁胶囊;②痰湿困脾证:温胆汤合天王补心丹加减;③心脾两虚证:九味镇心颗粒或党氏甘麦大枣汤;④火热内郁证:丹栀逍遥散颗粒或柴胡加龙骨牡蛎汤;⑤肝肾亏虚证:蒋氏补肝肾汤。(2)躁狂发作。①心肝火旺证:镇肝宁神方;②痰热扰神证:化痰泻火定神汤、连栀通窍安神汤、清神定狂汤或清神醒脑汤;③肝胆湿热证:龙胆泻肝汤。(3)其他证型。①肝气郁结证:改良通窍活血汤、升阳益胃针法;②肾阳不足证:金匮肾气汤;③痰结血瘀证:通窍活血汤加味;④气阴两虚,瘀血内停证:心脑欣丸;⑤血虚生风,火热扰神证:防己地黄汤。Bipolar disorder(BD)is a serious chronic emotional disorder with a high suicide rate and a common psychiatric disease.Traditional Chinese medicine(TCM)treatment based on syndrome differentiation of BD has unique advantages and good safety,which is expected to become a breakthrough in the treatment.Based on Expert Consensus on TCM Syndrome Differentiation Criteria for Bipolar Disorder by Professor Yin Dongqing and Professor Jia Hongxiao,this study collated the treatment protocols of BD with various syndrome types according to Meta-analysis of the existing literature in the database and evaluated the evidence level according to the evidence evaluation standard issued by the US Agency for Healthcare Research and Quality(AHRQ).(1)Depression attack.①Liver depression and spleen deficiency syndrome:Xiaoyaosan pills or Shugan Jieyu capsules,②Phlegm dampness and spleen stagnation syndrome:Wendantang modified with Tianwang Buxindan,③Heart and spleen deficiency syndrome:Jiuwei Zhenxin Granules or DANG's Ganmai Dazhaotang,④Fire heat and internal depression syndrome:Danzhi Xiaoyaosan Granules or Chaihu Longgu Mulitang,⑤Liver and kidney deficiency syndrome:JIANG's Buganshen Decoction.(2)Mania episode.①Heart and liver fire hyperactivity syndrome:Zhengan Ningshen Formula,②Phlegm heat harassing spirit syndrome:Huatan Xiehuo Dingshen decoction,Lianzhi Tongqiao Anshen decoction,Qingshen Dingkuang decoction or Qingshen Xingnao decoction,③Liver and gallbladder dampness-heat syndrome:Longdan Xiegantang.(3)Other syndrome types.①Liver qi stagnation syndrome:modified Tongqiao Huoxue decoction,Shengyang Yiwei Acupuncture,②Deficiency of kidney yang syndrome:Jingui Shenqitang,③Phlegm accumulation and blood stasis syndrome:modified Tongqiao Huoxue decoction,④Qi and Yin deficiency,stagnation of blood stasis syndrome:Xinnaoxin pills,⑤Syndrome of blood deficiency generating wind and fire heat harassing spirit:Fangji Dihuangtang.

关 键 词：中医 双相情感障碍 辨证分型 治疗策略 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R2-031R259R277.7