抑郁症临床症状分层与中医辨证分型的关系

doi:10.3736/jcim20110902

Abstract

On the basis of medical literature review and clinical research experience, the authors analyzed the reasons for low recognition rate of depression and poor progress of traditional Chinese medicine (TCM) differentiation of depression in this paper and put forward that depressive episode symptoms and the corresponding common terminology classification of Chinese and Western medicine should be the breakthrough points. Through symptom stratification and combination, as well as distinguishing between primary and secondary symptoms, the comprehensive integrative medicine clinical assessment of depression was explored so as to further obtain expert consensus and provide a methodology reference for the TCM differentiation of depression and the research of etiology and pathogenesis.

Key words: depression, seizures, neurobehavioral manifestations, syndrome classification, etiological factors (TCM), pathogenesis (TCM)

Sui Yue Hu, Su E Wang, Chun Hu Zhang. Relationship between symptom stratification and syndrome differentiation of traditional Chinese medicine for depressive episode. Journal of Chinese Integrative Medicine, 2011, 9(9): 933-936.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20110902

http://www.jcimjournal.com/EN/Y2011/V9/I9/933

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Figures/Tables 2

分层	症状诊断标准	供选择的对应性名词术语
核心症状	情绪低落(心境低落)	心情不好、压抑、悲伤、善悲易哭、郁郁寡欢、心里难受、喜太息、苦闷、表情沮丧^※、额头紧锁^※、眉间“川”字^※、无望、无助、无用（昼重夜轻）
	(1)兴趣丧失、无愉快感	高兴不起来、度日如年、空虚、兴趣索然、离群索居、自我封闭、愁眉苦脸^※、冷漠、无笑容^※
心理学症状群	(2)精力减退或疲乏感	力不从心、无精打采^※、精神萎靡^※、疲乏无力（倦怠乏力）、懒惰（懒散）、数欠伸
	(3)精神运动性迟滞或激越	迟滞：神思迟钝、健忘、脑子笨了、行动迟缓、效力低、呆坐^※、呆立^※、嗜睡、不吃不喝、木僵^※;激越：精神紧张、注意力不集中、苦思冥想、烦躁不安、忧心忡忡、恶闻声响
	(4)自我评价过低、自责,内疚感	自卑、自责、自罪、罪恶感、内疚
	(5)联想困难或自觉思考能力下降	思维迟缓、优柔寡断、犹豫不决、说话缓慢、少语寡言、胆怯易惊
	(6)反复出现想死的念头或有自杀、自伤行为	活着没意思、生不如死、悲观消极、自伤、悲观厌世、轻生念头、欲寻短见、痛不欲生、悲痛欲绝
生物学症状群	(7)睡眠障碍	入睡困难、少寐、多梦易醒、早醒、睡眠过多（嗜卧少动）
	(8)食欲降低或体重明显减轻	食欲下降、食不甘味、纳差、纳呆、体重下降（消瘦）、面黄肌瘦^※、营养不良
	(9)性欲减退	性欲减退、阳痿、快感缺失、闭经
其他症状群	焦虑症状	坐立不安、心烦意乱、胸闷、气短、心悸、出汗、尿频、肢体颤抖、惊恐
	非特异性躯体不适	面色无华^※、头晕头痛、全身疼痛、局部疼痛、形寒肢冷、肢体麻木、肌肉痉挛、视物模糊、咽喉梗塞、五心热、潮热、盗汗、胃部不适、腹胀、嗳气呃逆、恶心欲呕、消化不良、口干苦、便溏、便秘、月经不调
	精神病性症状	幻觉、幻听、妄想（由重到轻为：被害、罪恶、牵连、疑病、虚无、贫穷）、妄见妄闻、多疑善惑

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	实证类	虚或虚实夹杂类
常见证型	肝郁气滞、肝郁痰阻	—
少见证型	肝郁血瘀、肝郁化火、心肝火旺、湿浊中阻	肝郁脾虚、心脾两虚、肝郁肾虚阴虚火旺、肝肾阴虚、脾肾阳虚肝胆气虚、心神不宁、心肾不交

Relationship between symptom stratification and syndrome differentiation of traditional Chinese medicine for depressive episode

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