基于现代精神病学探讨抑郁症中医治疗实践中的若干问题＊

本文从现代精神病学视角认识抑郁症的中医治疗,认为抑郁症的临床辨证当以核心的精神症状为主,根据诊断类型不同、严重程度不等,分别采取不同的治疗方法。对于双相抑郁,其病机特点表现为阴虚阳亢,临床当以益阴调阳为主;对于单相抑郁的中、重度类型,可采用温阳开郁的治法;对于有明显季节性发作的患者,可借助中医五运六气理论,来探讨抑郁症的先天禀赋与其发作的关联性。此外,抑郁症治疗的疗效评价当以西医的疗效标准去评价,而抑郁症的中医治疗疗程,则需要循证医学的方法进行深入研究。

A Review of TCM Treatment of Depression from the Perspective of Modern Psychiatry

From the perspective of modern psychiatry, TCM dialectical treatment of depression is depended on core mental symptoms, the type of diagnosis and severity, and different treatment methods are adopted. Because the characteristics of bipolar depression are characterized by yin deficiency and yang hyperactivity, replenishing Yin and regulating yang should be the main strategy. For patients with moderate or severe depression, the treatment of Wenyang Kaiyu can be used. For other patients with obvious seasonal episodes, the theory of Chinese medicine, five movements and six qis can be used to explore the association between the congenital endowment of depression and its onset. In addition, the evaluation of the therapeutic effect of depression is evaluated by the efficacy standard of Western medicine, and the treatment course of Chinese medicine for depression is a problem that needs to be solved, and it needs in-depth study by evidence-based medicine.