浅析支气管哮喘并焦虑抑郁情绪临证辨治  

A brief analysis of the clinical diagnosis and treatment of asthma plus anxiety and depression

作　　者：余欢 帅云飞 戴孟庭 林莜岚 班斌斌 胡宇翔 赵欣宇 YU Huan

机构地区：[1]湖南中医药大学第一中医临床学院/湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学,湖南长沙410007

出　　处：《中医临床研究》2024年第29期130-135,共6页Clinical Journal Of Chinese Medicine

基　　金：湖南中医药大学研究生创新课题项目(2023CX97);湖南中医药大学本科生科研创新基金项目(2023BKS001);湖南省卫生健康委科研计划项目(20200289);湖南省自然科学基金项目(2020JJ4478)。

摘　　要：哮喘病名最早见于《丹溪心法》,为常见的肺系疾病之一,以咳嗽、哮鸣、气喘为主症。该病病势缠绵、病程反复,多给患者带来强烈的机体不适感,可引起焦虑、抑郁等情绪,并且随着原发疾病进展,临床表现复杂,严重影响疾病预后及痊愈周期。西医治疗方案存在严重依赖性,且多单纯针对呼吸道疾病,鲜有对于情志的针对性治疗,近期疗效尚可,却未能获得长期、稳固的后期疗效。现结合《黄帝内经》中经典论述,基于“五脏-五神-五志”相关理论,根据肺之“气-神”二者关系,进一步阐明哮喘合并焦虑抑郁情绪的病因病机,即以“形神失调”为病机的疾病,内风感召外风,邪气引触,咳喘为患,所郁在神,表现为情志不畅,所病在形。论治该病,无法完全隔绝“形-神”二者,与中医“整体观念”相应,临床中在解除形体之“郁”的同时要兼顾神志之“郁”的治疗,当形神同治,即施予有形的“治脏”处方和无形的“治神”处方,治形当以宣肺达和汤化裁,达疏肝理肺、复气机升降之妙,治神以言语为药,对患儿及家属双方进行心理干预,以奏调畅情志、以情胜情之功,二者结合应用于临床常可事半功倍。现拟从新视角探讨哮喘兼情志疾病的中医病因病机、治则治法,以期拓宽该病辨证思路。Asthma,whose name first appeared in Danxi Xinfa(《丹溪心法》),is one of the common pulmonary diseases,mainly characterized by cough,wheezing,and asthma.The disease is persistent and recurrent,brings strong physical discomfort to patients,as well as anxiety,depression,and other emotions.With the progression of the primary disease,its clinical manifestations are complex,seriously affecting the prognosis and recovery cycle of the disease.There is a serious dependence on Western medicine treatment,and most of the treatment is only for respiratory diseases,with little targeted treatment for emotions.The short-term efficacy is acceptable,but the long-term and stable later efficacy has not been obtained.In this article,combined with the classic discourse in Huangdi Neijing(《黄帝内经》),based on the theory of“Five Zang Organs(脏),Five Spirits,and Five Consciousnesses”,and according to the relationship between Qi(气)and Spirit of the lungs,it further elucidates the etiology and pathogenesis of asthma plus anxiety and depression,that is,the disease with“form and spirit imbalance”as the pathogenesis is due to the internal wind inspired by external wind,the evil energy triggers,coughing and wheezing are symptoms,with depression in the mind,poor emotional expression as clinical manifestation,and illness in the form.When it comes to the treatment of this disease,the form and spirit cannot be completely separated,which corresponds to the holistic concept of traditional Chinese medicine.In clinical practice,while relieving the depression of the body,it is also necessary to consider the treatment of the depression of the spirit.The depression of the form and spirit should be treated simultaneously,that is,the tangible prescriptions for treating Five Zang Organs and intangible prescriptions for treating the spirit should be given simultaneously.In terms of treating the form,the Xuanfei Dahe decoction(宣肺达和汤)is used to achieve the wonderful effects of soothing the liver and regulating the lungs to re

关 键 词：支气管哮喘 焦虑抑郁情绪 郁证 形神同调 宣肺达和汤 

分 类 号：R256.12[医药卫生—中医内科学]