摘要
对有关厥证的文献进行梳理和分类,提出"痛厥(疼痛性厥证)"与"郁厥(郁证性厥证)"新概念,并重点探讨"郁厥"的病脉证治。认为厥仆可以是郁证的表现之一,凡由情志病因导致气机一时升降乖张而厥仆者即是郁厥。郁厥包括气厥气实之证、部分血厥血逆之证及痰厥。中恶缘于精神衰弱,主要因气质禀赋"内生性情志病因"所引起,是郁厥的重要类型。气机逆乱是郁厥的基础病机,为气厥、为中恶;血随气逆为血厥,痰随气逆为痰厥;瘀血与痰浊蒙蔽清窍都是郁厥的重要病机。郁厥具有独特的临床特征,伴有显性郁证和(或)隐性郁证的表现。郁厥治疗的重要性和必要性依次为厥仆前、厥仆后、厥仆中,其治疗主要有疏肝理气解郁、养心安神定志、活血化瘀、涤痰祛浊、调补脏腑阴阳气血之五大原则。郁厥相当于现代医学之心理性晕厥及由心理精神障碍诱发的血管迷走性晕厥。
Assorted and classified the related literature of syncope syndrome, this paper proposed the new concept of ＂pain syncope ＂ （ syncope due to pain） and ＂ depression syncope ＂ （ syncope due to depression syndrome）, and mainly discussed the syndrome differentiation and treatment of ＂ depression syncope ＂. It considered that syncope was one of the manifestations of depression syndrome. Person suffered from syncope that caused by the disturbance of qi-movement mediated by the emotional factors,which is called as syncope due to depression syndrome. Syncope due to depression syndrome includes syncope with qi excess, part syncope with blood-inverse and syncope with phlegm disorder. ＂ Zhong e＂ , as an important kind of syncope due to depression syndrome, is due to psychasthenia and mainly caused by the temperament endowment as ＂the internal emotional factors＂. Qi adverseness is considered as the basic pathogenesis of syncope due to depression syndrome,which presented the syndrome of syncope with qi disorder and ＂Zhong e＂. Bleeding due to qi reversed flow can be expressed as syncope with blood disorder,phlegm due to qi reversed flow can be expressed as syncope with phlegm disorder. Stagnant blood and phlegm clouding the clear orifices are also the important pathogenesis of syncope due to depression syndrome. Syncope due to depression syndrome show peculiar clinical features,and often accompanied by the manifestations of dominant and recessive depression syndrome. According to the importance and necessity, the therapy point of syncope due to depression syndrome is before syncope, after syncope and syncope in turn. The five treatment principles for syncope due to depression syndrome are soothing liver and regulating qi movement, invigorating heart to tranquilize mind, activating blood and dissolving stasis, removing phlegm and turbid, regulating viscera as well as yin and yang, qi and blood. Syncope due to depression syndrome can be regarded as psychological syncope and vasovagal syncope induced by psychological disorders in modern medicine.
出处
《上海中医药杂志》
2016年第10期5-11,共7页
Shanghai Journal of Traditional Chinese Medicine
基金
科技部"十二五"国家重大新药创制(创新药物研究开发技术平台建设)项目(2012ZX09303009-001)
上海巿卫计委进一步加快中医药事业发展三年行动计划项目(ZY3-CCCX-3-2007)
上海市教委重点学科(中药临床药理学)项目(J50303)
高等学校博士学科点专项科研基金新教师类资助课题(20123107120002)
关键词
郁证
厥证
中恶
情志病因病机
从郁论治
心理性晕厥
depression syndrome
syncope syndrome
＂ Zhong e＂
emotional etiology and pathogenesis
treatment based on relieving depression
psychological syncope
