摘要
抑郁和失眠是最常见的精神障碍类疾病,临床患者往往呈现“共病”状态。现代医学认为,脊柱运动系统失衡引起的疼痛、脊柱相关性内脏疾病、中枢神经系统-免疫-内分泌网络的紊乱以及遗传易感性增加等因素,都可同时引发抑郁和失眠。中医治疗抑郁共病失眠有独特优势,神机失用、阴阳失调、脏腑气血运行不畅为抑郁与失眠共同病机。中医“督脉体系”包含督脉及其联络的经络和脏腑,对应现代医学脊柱关节运动系统及中枢神经系统,其功能为调神治脑、统领诸阳、连络脏腑,与抑郁共病失眠病机十分契合。该文通过梳理总结了基于“督脉体系”实施的中医外治法,涉及针刺、灸疗、推拿手法、拔罐、刮痧、五行音乐及外治综合疗法等,从解剖形态学、神经内分泌学、分子生物学等层面为中医外治法治疗抑郁共病失眠的临床疗效提供科学依据。“督脉体系”可能是未来研究抑郁共病失眠的潜在靶点,并成为临床治疗该病的首选切入点。
Depression and insomnia are the most common mental disorders,and clinical patients often present a“comorbid”state.Modern medicine believes that factors such as pain caused by imbalances in the spinal motor system,spinal-related visceral diseases,disorders of the central nervous system-immune-endocrine network,and increased genetic susceptibility can all cause depression and insomnia at the same time.Traditional Chinese medicine(TCM)has unique advantages in treating the comorbid disease of depression and insomnia.The disorder of spirit,the disharmony of Yin and Yang,and the malfunctioning of Qi and blood in Zang-Fu are common pathogenesis of depression and insomnia.The governor vessel system consists of the governor vessel and the major meridians and organs connected to it,corresponding to the spinal joint movement system and the central nervous system of modern medicine.The governor vessel system can harmonize the brain and spirit,regulate Yang of the whole body and connect five Zang organs and six Fu organs,which is properly consistent with the pathogenesis of comorbid depression and insomnia.This article summarizes the external treatment methods of TCM implemented based on the governor vessel system,involving acupuncture,moxibustion,massage techniques,cupping,scraping,five elements music and external treatment comprehensive therapy,etc.And we provide scientific basis for the clinical efficacy of external treatment of TCM in the treatment of depression and insomnia from the aspects of anatomy,neuroendocrinology,and molecular biology.The governor vessel system could be a promising focus for future research on comorbid depression and insomnia,and may serve as the primary entry point for clinical treatment of this condition.
作者
严梦蝶
付雪
张治强
杨佐琴
YAN Mengdie;FU Xue;ZHANG Zhiqiang;YANG Zuoqin(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China;Chengdu Pidu District Hospital of Traditional Chinese Medicine,Chengdu 611730,Sichuan,China)
出处
《辽宁中医药大学学报》
CAS
2024年第10期201-211,共11页
Journal of Liaoning University of Traditional Chinese Medicine
基金
四川省自然科学基金项目(2022NSFSC1493)
成都市医学科研课题(2021476)。
关键词
督脉
抑郁
失眠
外治法
针灸
推拿
governor vessel
depression
insomnia
external treatment
acupuncture and moxibustion
Tuina
