震后惊恐障碍中医病机特征及研究思路探析
摘要
震后惊恐障碍是地震后高发的精神心理性疾病,对家庭、社会影响严重,中医药具有自身的优势和特色。从"肝虚则恐"理论着眼,分析了震后惊恐障碍的中医病机和发生、发展规律,并结合惊恐反射的现代研究成果,提出脑内5-HT是连结中医肝虚和恐惧反射的关键靶分子,并从"方证相关"的角度,以临床研究结果加以佐证,最后提出了震后惊恐障碍的研究思路和着眼点。
引文
[1]赵高锋,杨彦春,张树森,等.汶川地震极重灾区780名受灾群众心理状况调查[J].中国循证医学杂志,2008,8(10):815-819.
[2]姚一民,陈华,唐佩福,等.地震骨科伤员72例创伤后应激障碍调查[J].军医进修学院学报,2008,29(5):429.
[3]王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状.上海精神医学,2006;18(6):372-375.
[4]郭阳,陈爱敏,林浩春,等.“5.12"汶川大地震伤员心理应激状况调查[J].南方医科大学学报,2008,28(7):1114-1117.
[5]Kessler RC,Borges G,Walters EE.Prevalence of andrisk factors for lifetime suicide attempts in the National Co-morbidity Survey[J].Arch Gen Psychiatry,1999,56(7):617-626.
[6]陶嵘,张亚林.杏仁核在条件恐惧中神经生物学机制的研究进展[J].中华精神科杂志,2006,39(1):58-60.
[7]刘文义,张锦.恐惧条件反射机制研究的新进展[J].国际麻醉学与复苏杂志,2007,28(1):66-69.
[8]郑佳威,吴玺宏,李量.外侧杏仁核在恐惧性条件化学习和记忆中的作用[J].生理科学进展,2007,38(3):269-273.
[9]喻东山,梅安昌.惊恐障碍的发生机制[J].四川精神卫生,2009,22(2):122-124.
[10]Hui-Li Han,Jin-Xia Dai,Meng Tian,et al.Enhancedcontextual fear memory in central serotonin-deficient mice[J].Neuroscience Research,2009,65:Supplement1:S183.
[11]Jack M Gorman;Justine M Kent;Gregory M Sullivan;Jeremy D Coplan Neuro-anatomical hypothesis of panicdisorder,revised[J].The American Journal of Psy-chiatry,2000,157:493-503.
[12]Eduard Maron and Jakov Shlik,Serotonin Function inPanic Disorder:Important,But Why?[J].Neuropsy-chopharmacology,2006:1-11.
[13]Jack M Gorman;Justine M Kent;Gregory M Sullivan;Jeremy D Coplan Neuroanatomical hypothesis of panicdisorder,revised[J].The American Journal of Psy-chiatry,2000,157:493.
[14]young Yoon,Jong-Chul Yang,Heon-Jeong Lee,et al.The association between serotonin-related gene polymor-phisms and panic disorder[J].Journal of Anxiety Dis-orders,2008,(22):1529-1534.
[15]Vanessa de Paula Soares,Hélio Zangrossi Jr.Stimulationof 5-HT1A or 5-HT2A receptors in the ventrolateral periaq-ueductal gray causes anxiolytic,but not panicolytic-likeeffect in rats[J].Behavioural Brain Research,2009,(197):178-185.
[16]Frederico G.Graeff,Cristina M.Del-Ben.Neurobiologyof panic disorder:From animal models to brain neuroim-aging[J].Neuroscience and Biobehavioral Reviews,2008,(32):1326-1335.
[17]陈家旭.中医肝本质现代研究进展[J].中国中医基础医学杂志,1998,7(4):58.
[18]严灿,徐志伟,李艳,等.调肝、补肾、健脾方药对慢性心理应激大鼠单胺类神经递质影响的比较研究[J].中国中西医结合杂志,2002,22(12):925-927.
[19]李明放.酸枣仁汤治疗广泛性焦虑症的临床观察[J].中华现代内科学杂志,2007,4(4):350-351.
[20]郑志峰.柴胡加龙牡汤治疗惊恐障碍30例[J].浙江中西医结合杂志,2001,11(2):92.
[21]贾智捷.中药与舍曲林治疗惊恐障碍疗效观察[J].辽宁中医杂志,2005,32(11):1181.
[22]代渊,张梅林,徐世军.疏肝滋肾法治疗震后惊恐障碍20例[J].四川中医,2009,27(3):59-60.
[2]姚一民,陈华,唐佩福,等.地震骨科伤员72例创伤后应激障碍调查[J].军医进修学院学报,2008,29(5):429.
[3]王志阳,汤月芬,施慎逊.创伤后应激障碍国内研究现状.上海精神医学,2006;18(6):372-375.
[4]郭阳,陈爱敏,林浩春,等.“5.12"汶川大地震伤员心理应激状况调查[J].南方医科大学学报,2008,28(7):1114-1117.
[5]Kessler RC,Borges G,Walters EE.Prevalence of andrisk factors for lifetime suicide attempts in the National Co-morbidity Survey[J].Arch Gen Psychiatry,1999,56(7):617-626.
[6]陶嵘,张亚林.杏仁核在条件恐惧中神经生物学机制的研究进展[J].中华精神科杂志,2006,39(1):58-60.
[7]刘文义,张锦.恐惧条件反射机制研究的新进展[J].国际麻醉学与复苏杂志,2007,28(1):66-69.
[8]郑佳威,吴玺宏,李量.外侧杏仁核在恐惧性条件化学习和记忆中的作用[J].生理科学进展,2007,38(3):269-273.
[9]喻东山,梅安昌.惊恐障碍的发生机制[J].四川精神卫生,2009,22(2):122-124.
[10]Hui-Li Han,Jin-Xia Dai,Meng Tian,et al.Enhancedcontextual fear memory in central serotonin-deficient mice[J].Neuroscience Research,2009,65:Supplement1:S183.
[11]Jack M Gorman;Justine M Kent;Gregory M Sullivan;Jeremy D Coplan Neuro-anatomical hypothesis of panicdisorder,revised[J].The American Journal of Psy-chiatry,2000,157:493-503.
[12]Eduard Maron and Jakov Shlik,Serotonin Function inPanic Disorder:Important,But Why?[J].Neuropsy-chopharmacology,2006:1-11.
[13]Jack M Gorman;Justine M Kent;Gregory M Sullivan;Jeremy D Coplan Neuroanatomical hypothesis of panicdisorder,revised[J].The American Journal of Psy-chiatry,2000,157:493.
[14]young Yoon,Jong-Chul Yang,Heon-Jeong Lee,et al.The association between serotonin-related gene polymor-phisms and panic disorder[J].Journal of Anxiety Dis-orders,2008,(22):1529-1534.
[15]Vanessa de Paula Soares,Hélio Zangrossi Jr.Stimulationof 5-HT1A or 5-HT2A receptors in the ventrolateral periaq-ueductal gray causes anxiolytic,but not panicolytic-likeeffect in rats[J].Behavioural Brain Research,2009,(197):178-185.
[16]Frederico G.Graeff,Cristina M.Del-Ben.Neurobiologyof panic disorder:From animal models to brain neuroim-aging[J].Neuroscience and Biobehavioral Reviews,2008,(32):1326-1335.
[17]陈家旭.中医肝本质现代研究进展[J].中国中医基础医学杂志,1998,7(4):58.
[18]严灿,徐志伟,李艳,等.调肝、补肾、健脾方药对慢性心理应激大鼠单胺类神经递质影响的比较研究[J].中国中西医结合杂志,2002,22(12):925-927.
[19]李明放.酸枣仁汤治疗广泛性焦虑症的临床观察[J].中华现代内科学杂志,2007,4(4):350-351.
[20]郑志峰.柴胡加龙牡汤治疗惊恐障碍30例[J].浙江中西医结合杂志,2001,11(2):92.
[21]贾智捷.中药与舍曲林治疗惊恐障碍疗效观察[J].辽宁中医杂志,2005,32(11):1181.
[22]代渊,张梅林,徐世军.疏肝滋肾法治疗震后惊恐障碍20例[J].四川中医,2009,27(3):59-60.
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