摘要
抑郁症是指以显著而持久的情绪低落、活动能力减退、思维与认知功能迟缓为临床主要特征的一类情感性精神障碍,部分患者存在自伤、自杀行为,可伴有妄想、幻觉等精神症状。抑郁症与脑、心存在明确的发病关联,但没有完整的学说或机制可以解释抑郁症发病的全部方面。中医学认为脑和心主导神志的生成与变化,将抑郁症归于神志病范畴,临床多按郁病、脏躁、百合病等论治。三焦是主导气化的重要藏腑,其解剖实质历来存在争议。近年来有关三焦实质结构的研究取得重要进展,发现三焦与"间充质"在结构和功能上存在高度一致性。"间充质"是一个由复杂胶原纤维网支撑的液体间隙,广泛分布全身各处,而且区别于已知组织器官,是一种综合信息沟通、物质交换、能量代谢等功能的庞大器官。三焦寓于脑、心的结构之中,联系并沟通脑、心,由此"脑-心-三焦"构成一个具有紧密生理病理联系的整体。以"脑-心-三焦"关联为基础,以气化为核心环节,阐发抑郁症的发病机制,提出抑郁症的关键病机为"脑心阳衰,焦阻气郁",以期完善中医对抑郁症发病机制的认识,促进中医对脑病、三焦实质等理论的进一步探索。
Major depressive disorder(MDD)is an affective disorder characterized by significant and long-lasting depression,hypoactivity,and thinking and cognitive retardation.Some patients may conduct selfhram or suicide and have delusion,hallucination,and other mental symptoms.MDD is believed to be correlated with brain and heart,but there is no complete theory or mechanism fully explaining the pathogenesis of MDD.Traditional Chinese medicine(TCM)holds that the brain and heart dominate the formation of and change in mind,and MDD falls into the category of mental disease.It is mainly diagnosed as depression,visceral agitation,or Lily disease.Triple energizer is a key zang-fu organ that governs Qi transformation.There has always been some controversy about its anatomical structure.In recent years,important progress has been made in the research on the substantive structure of triple energizer.It is found that the structure and function of triple energizer are highly consistent to those of"mesenchyme",a fluid space supported by a complex network of collagen fibers and widely distributed throughout the body.Different from known tissues and organs,it is a large organ responsible for information communication,material exchange,and energy metabolism.The triple energizer is partially contained in the structure of brain and heart and connects with the brain and heart,thus forming a"brain-heart-triple energizer"system with close physiological and pathological connections.With the association of"brain-heart-triple energizer"as the basis and Qi transformation as the core link,this paper elucidated the pathogenesis of MD and put forward that MDD resulted from"brain and heart Yang deficiency and Qi depression due to triple energizer obstruction",so as to improve TCM understanding of the pathogenesis of MDD and perfect the TCM theories of encephalopathy and triple energizer.
作者
金雨静
翟吴剑文
黄世敬
JIN Yu-jing;ZHAI-WU Jian-wen;HUANG Shi-jing(Guang'anmen Hospital,Chinese Academy of Chinese Medicine Sciences,Beijing 100053,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第4期219-226,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81573790,81603443)
中央级公益性科研院所基本科研业务费专项资金自助项目(ZZ15-XYLCQ-04)。
关键词
抑郁症
三焦
脑病
病机
major depressive disorder
triple energizer
encephalopathy
pathogenesis
