基于五脏藏神与中医情志理论探讨惊恐障碍的成因与证治  

Exploring the Causes and Treatment of Panic Disorder Based on Theory of Five Zang Organs Producing Spiritual and Mental Activities and Emotional Theory in Traditional Chinese Medicine

作　　者：谢逸飞 冯敏超 罗芳[2] 符文彬[3] 孙录[1] XIE Yi-Fei;FENG Min-Chao;LUO Fang;FU Wen-Bin;SUN Lu(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangxi University of Chinese Medicine,Nanning 530000 Guangxi,China;Dept.of Acupuncture and Moxibustion,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]广西中医药大学,广西南宁530000 [3]广东省中医院针灸科,广东广州510120

出　　处：《广州中医药大学学报》2024年第12期3343-3349,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药高质量发展传承创新提升工程专项(粤财社[2022]102号);广州中医药大学“双一流”与高水平大学学科协同创新团队项目(编号:2021xk22);符文彬广东省名中医传承工作室(粵中医办函[2020]1号);广州中医药大学符文彬教授教学名师工作室(广中医校办[2020]75号)。

摘　　要：惊恐障碍(panic disorder)是一种反复发作的慢性精神疾病,其确切的发病机制尚未明确。西医治疗该病疗效确切,但药物副作用明显。在中医形神一体观的指导下,基于五脏藏神与中医情志理论治疗惊恐障碍可兼顾“治”与“防”,打破惊恐障碍反复发作的恶性循环。该文对五脏藏神与“中医情志理论”的理论内涵及其在指导治疗惊恐障碍的应用方面进行梳理与总结,认为五脏不能藏神是惊恐障碍发生的根本原因,形神不调是惊恐障碍的发病基础,情志所伤是惊恐障碍发生的诱发因素。辨证施治需首辨虚实,虚证当分清何脏为虚,实证当分清气滞、痰湿、瘀血何种邪气为主。治疗总以安神为要;中医治疗惊恐障碍的方法有中药治疗、针灸治疗、埋线疗法和情志疗法等。基于五脏藏神与中医情志理论探讨惊恐障碍的治疗可为惊恐障碍的多维度临床诊疗提供思路。Panic disorder(PD)is a kind of recurrent chronic psychiatric disorder,and its exact pathogenesis has not yet been clarified.Western medicine for PD can achieve certain efficacy,but has obvious side effects.Under the guidance of the view of physique-spirit integration in traditional Chinese medicine(TCM),the management of PD should include the measures for treatment and prevention with reference to the theory of five zang organs producing spiritual and mental activities and emotional theory in TCM,so as to break the vicious cycle of recurrent attacks of PD.This paper sorted out the theoretical connotations of the five zang organs producing spiritual and mental activities and emotional theory in TCM,and summarized their application in guiding the treatment of PD.It is indicated that five zang organs failing in producing spiritual and mental activities is the root cause of PD,the disharmony of physique and spirit is the basic pathogenesis of PD,and the injury of emotions is the triggering factor of PD.For the syndrome differentiation and treatment of PD,the identification of the deficiency syndrome and excess syndrome should be done firstly.The differentiation of the deficiency syndromes aims to identify the deficiency of any of zang organs,and the differentiation of the excess syndrome aims to find out the predominant pathogens from qi stagnation,phlegm-damp,and blood stasis.The goal of PD treatment is to tranquilize the spirit,and the TCM therapies PD include Chinese medicine therapy,acupuncture and moxibustion therapy,acupoint catgut embedding therapy,and emotional therapy.The treatment of PD based on the theories of five zang organs producing spiritual and mental activities and emotional theory in TCM will provide ideas for the multidimensional treatment of PD.

关 键 词：惊恐障碍 五脏藏神 中医情志理论 形神不调 情志所伤 辨虚实 安神 

分 类 号：R277.749.4[医药卫生—中医学]