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2012年09月21日
ZhaoZhiFu treatment psychosomatic disease experience
Editor's note: China academy of traditional Chinese medicine hospital professor gate ZhaoZhiFu for many years engaged in the diagnosis and treatment of TCM psychosomatic disease and rich experience, the effect significantly, and founded the "traditional Chinese medicine syndrome differentiation and treatment system can psychosomatic medicine". This AD hoc column described ZhaoZhiFu treatment mental and physical and mental disease syndrome differentiation thoughts and methods.
Using the firm soft differentiation of symptoms and signs treatment of anxiety
FanGuiQing - the Beijing tongzhou district of combining traditional Chinese and western medicine hospital fractures
China's traditional Chinese medicine to
Along with the social life rhythm speeding up, work and life pressure increases, anxiety incidence increasing year by year. Traditional Chinese medicine and no "anxiety" name, but with "hysteria", "jing", "fear", "with", "palpitation", "insomnia" and so on the close. The doctor of traditional Chinese medicine thinks the disease belongs to calm temperament disease category, excessive anxiety, nervousness and even fear is the most outstanding performance.
Etiology and pathogenesis
For anxiety etiology, ZhaoZhiFu will its summarized as internal cause (upright virtual) and external (evil real) two. Internal cause more for natural endowment weak (including psychological quality and physiological quality low), and for masculine body. More external cause for social environment factors (such as negative life events, work and family pressure, bad competition, etc.) and personality characteristics (such as masculine temperament impatience, upset irritability, emotional, phonetic sound loud and clear, the pursuit of perfect, etc.) and lead to a very calm temperament, the seven emotions mainly anger is given priority to. And the external characteristic is a pole in the disease process plays a very important role in promoting.
Anxiety first general in empirical, because of the crisis of governance, or characteristic of the stimulus to strengthen or continuous lead to false or true inclusion of syndrome, its pathogenesis evolution finally can be turned into deficiency syndrome. Anxiety clinical manifestation in the mood of anxiety, insomnia is given priority to, at the same time both easy to confuse headache, dizziness, head expansion, difficulty breathing, fear, gastrectasia, bosom is frowsty etc and certificate, general healers in the treatment with more, calming nerves is given priority to, but the effect is not good. In the most easily characteristic pathogenic anxiety appeared in ferrite masculine snapping the crowd. The sun be the spirit KangCheng masculine, YangCheng is facilitation fire, and wound Yin, and gradually appear of Yin deficiency syndrome; Yin and Yang interacting, YinSun and Yang, Yin and Yang deficiency in two of the card.
Liver storing blood, main drain, adjustable chang characteristic, have the most easily characteristic is very hurt liver, so the key pathogenesis in liver, and at the same time, influence the heart, spleen, stomach and kidney. Liver for just dirty, body Yin and Yang, for ferrite masculine temperament, easy to drain too. Liver drain too is facilitation fire sad overcast; Liver willy wonka spleen soil, YinSun day long will surely and Yang, appear spleen Yang deficiency syndrome Yang transport change.
Clinical points
Etc. On inverse visible emotional depression, upset irritability, belching frequency, nausea and vomiting, palpitation restless, dizziness head heavy, XiongGe QiNi, red tongue moss white, vein string; Darling the fire visible quick temper, be agitated irritability, easy to anxiety, dizziness, headache, head expansion fever, oropharynx dry, bitter taste; Spleen deficiency stomach visible chest threat pain, good heave a deep sigh, less food's stay, abdominal distension loose stool, little gas lazy speech, the form angular, brothers don't temperature, tongue reddish, moss white, vein string fine. Thermal perturbation mind is see palpitation restless, threat expansion chest distress, insomnia, much dream, difficulty sleeping, Liver Yin deficiency appeared threat rib pain, mesh displacement have appeared two dry eye, Spleen Yang deficiency luck change to accept less visible, gastrectasia, and thin; Spleen main limbs, Yang warm dereliction of duty, visible limbs weakness, lower limb faint cold. Red tongue moss white slippery, vein string fine.
Treatment experience
For characteristic factors of the disease, ZhaoZhiFu advocate "first for the heart, after cure their body", from the view of the whole traditional Chinese medicine, patients are advised to establish the good life habit, increase aerobic exercise (walk is appropriate), change the cognitive behavior, change the character of impatience. In drug treatment, ZhaoZhiFu advocate soft liver to hold the drain, purging liver to tranquilize the mind, with adjustable chang "shugan decoction" characteristic, Yin to slow heart hand, help Yang to make up for insufficiency of the spleen, achieve chills and fever level tone, Yin and Yang phase economic equilibrium state. Cannot see the liver drain dereliction of duty with radix bupleuri, for liver drain dereliction of duty have drain too and drain supplied points. For liver drain too liver prosperous the card should choose soft liver of law, such as liver with will strengthen liver drain, aggravating illness. Liver of flourishing certificate in ferrite masculine irritable, soft liver preferred radix paeoniae alba, take its acid reducing the sex to purging liver prosperous, slow its drain too, namely neijing cloud: "using symplectic complement, diarrhea with acid. The law of "shugan decoction" is suitable for liver drain as the proof of stomach, this card in ferrite Yin flexible slow, radix bupleuri for soothing the liver XieYu preferred.
The inverse etc. With inhibitory liver drop inverse medicine such as inula flower, red ochre and so on, the fire heart with bitter drain call, light permeability yangxin medicine to tranquilize the mind, such as gardenia, lobster sauce, cortex moutan, rhizoma coptidis, radix scutellariae, cortex phellodendri, bamboo leaf, lotus seed, etc.; With essien scattered stomach WenTong, bitter drain down the product with soothing the liver qi, such as radix bupleuri, fructus aurantii immaturus, green tangerine peel, pericarpium citri reticulatae, etc., thermal perturbation mind with acid reducing its fire, acid GanHua Yin to calm the nerves, calming, such as salvia miltiorrhiza, platycladi seed, the seed of wild jujube, tuber fleeceflower, lily, roasted liquorice etc; With mineral kind of medicine to flat liver latent Yang, town heart calm the nerves, such as burnt magnet, red ochre, mother of pearl, born keel, raw oyster, etc.; The spleen turn wet to rise spleen Yang as rhizoma atractylodis macrocephalae, poria, radix puerariae, rhizoma dioscoreae, etc.; Releasing temperature cold use cannon ginger, cumin, white nutmeg, galangal to help spleen Yang. And assist with chrysanthemum, mulberry leaf, mint, etc XinSheng scattered light the product to help connect fully sun be the spirit, alleviate head expansion head hot symptoms. Semen raphani unobstructed fluctuation qi to exhaust polluted; Radix achyranthis bidentatae lead heat down; Less with sand benevolence, chicken's gizzard-membrane to help the spleen to transport and digest, in case of mineral medicine town hurt a stomach.
Medical record for example
Patients, male, 17 years old, because of the pressure of study, be agitated, headache half a year, in April 2009 and has to see a doctor.
Disease see be agitated, headache, giddy head bilges, the eye dry eye expansion, restlessness, diet, can sleep. Red tongue, moss yellow greasy, vein string. Patients with irritable, we are learning in sick, who see a doctor to settle the hospital, first diagnosed with obsessive-compulsive disorder, after diagnosis for anxiety disorders, at present suit west peptide and Laura plank.
Four diagnostic methods $ginseng, diagnosis of be agitated, differentiation of symptoms and signs for the liver fire on inflammation, treat by purging liver lowering.
Prescription: gardenia 10 grams, cortex moutan 12 grams, light black bean sauce 10 grams, chrysanthemum 12 grams, mint 6 grams, semen cassiae 20 grams, radix scutellariae 10 grams, red ochre (first Fried) 30 grams, radix achyranthis bidentatae 30 grams, salvia miltiorrhiza 30 grams, cinnamon 3 grams, haliotis first 30 grams, born liquorice 6 grams, Chinese wolfberry 20 grams. 7 agent, water frying, points 2 times after meals. Change the cognitive, the adjustment point of view; Increase aerobic exercise, do daily a sweat, walk ten thousand steps; Ensure that evening 10 o 'clock in the morning to 6 o 'clock eight hours get enough sleep.
On April 20th return visit, v. symptoms such as before, to the original party and Chinese yam 20 grams.
On April 27 return visit, v. headache, be agitated reduce, disease such as more than before, and keep the original FangJiFu 14 agent after the disease significantly reduce, then take 7 agent after recovery.
According to the patients ferrite masculine, quick temper, complex because of the pressure of social environment, the liver drain too, the excess etc., the invert fire, causing the liver fire on inflammation, appear have a headache, giddy head expansion, eye dry eye expansion, be agitated, restlessness wait for a symptom, so use purging liver lowering, lead heat descending, harmonic qi and blood, Yin and Yang phase ji.