中医心身医学——心身疾病的刚柔辩证

《中医心身医学——心身疾病的刚柔辩证》由会员分享，可在线阅读，更多相关《中医心身医学——心身疾病的刚柔辩证（81页珍藏版）》请在装配图网上搜索。

1、1中医心身医学中医心身医学心身疾病的刚柔辩证心身疾病的刚柔辩证中国中医科学院中国中医科学院 赵赵 志志 付付 Psychosomatic Medicine of Psychosomatic Medicine of Traditional Chinese Medicine(TCM)Traditional Chinese Medicine(TCM)Rigid-Gental DifferentiationRigid-Gental Differentiationzhao zhizhao zhi fu fu 2 一、应对心身疾病的挑战一、应对心身疾病的挑战 1、Coping with psychosom

2、atic diseases 二、中医心身医学理论与临床二、中医心身医学理论与临床 2、The theory and clinical research of TCM Psychosomatic Medicine3一、应对心身疾病的挑战1.Coping with psychosomatic diseases4 随着世界经济的发展、社会的进随着世界经济的发展、社会的进步和科学的日新月异，人类的疾病谱步和科学的日新月异，人类的疾病谱和死亡谱发生了根本的转变。和死亡谱发生了根本的转变。Disease spectrum and the cause of death have changed dramat

3、ically over the years,which have changed from mal nutrition and infection mainly to physical disorder resulting from mental or emotional and social causes,which are psychosomatic diseases.5 由过去的传染病和营养不良由过去的传染病和营养不良为主，转化为由心理社会因素生为主，转化为由心理社会因素生活行为等因素引起的心身疾病为活行为等因素引起的心身疾病为主主.医学模式已由生物医学模式向医学模式已由生物医学模式向生

4、物生物心理心理社会医学模式转化。社会医学模式转化。6 中国也进入快速发展时期，社会转中国也进入快速发展时期，社会转型，市场经济，竞争加剧，人际关系复型，市场经济，竞争加剧，人际关系复杂，情绪压力增大。杂，情绪压力增大。2121世纪是一个快速多变的，充满了世纪是一个快速多变的，充满了压力与挑战的时代压力与挑战的时代 21st century is a time full of rapid changes,pressure and challenges.7Psychosomatic Diseases in ChinaThe Healthy15%The Sub-healthy70%Others6%其

5、他15%Psychosomatics9%The ill亚亚健健康康健康疾疾病病心身疾病其他8 1、消化系统心身疾病：、消化系统心身疾病：胃和十二指肠溃疡胃和十二指肠溃疡(胃痛胃痛)、慢性胃炎、慢性胃炎(胃痞胃痞)、胃神经症胃神经症(胃胀胃胀)、溃疡性结肠炎、溃疡性结肠炎(泄泻、痢疾泄泻、痢疾)、肠神经症肠神经症(泄泻泄泻)、习惯性便秘、习惯性便秘(便秘便秘)、慢性肝、慢性肝炎炎(胁痛胁痛)、慢性胆囊炎、慢性胆囊炎(胆胀胆胀)、等。、等。Psychosomatic diseases in the digestive system include gastric and duodenal ulce

6、r(stomachache),chronic gastritis(mass in the stomach),gastric neurosis(distension of the stomach),ulcerative colon(diarrhea and dysentery)9 2、心血管系统心身疾病：、心血管系统心身疾病：原发性高血压病原发性高血压病(眩晕眩晕)、原发性低血压病、原发性低血压病(眩晕眩晕)、冠心病冠心病(胸痹胸痹)、心律失常、心律失常(心悸心悸)、心脏神经症、心脏神经症(胸胸痹痹)、雷诺氏症、雷诺氏症(厥证厥证)、受体高敏症受体高敏症(心悸心悸)、心因性晕厥心因性晕厥(厥症厥

7、症)等。等。Psychosomatic diseases in the cardiovascular system include primary hypertension(dizziness),essential hypotension(dizziness),coronary heart disease(obstruction of qi in the chest)10 3、呼吸系统心身疾病：、呼吸系统心身疾病：支气管哮喘支气管哮喘(哮喘哮喘)、过度换气综合症、过度换气综合症(喘证喘证)、神经性咳嗽神经性咳嗽(肝咳肝咳)等。等。Psychosomatic diseases in the re

8、spiratory system include bronchial asthma(asthma),hyperventilation syndrome(dyspnea).syndrome)and nervous cough(dry cough11 4、神经系统心身疾病：、神经系统心身疾病：脑卒中脑卒中(中风中风)、癫痫、癫痫(痫证痫证)、血管神经性头痛、血管神经性头痛(头痛头痛)、紧张性头痛、紧张性头痛(头痛头痛)等。等。Psychosomatic diseases in the nervous system include cerebral apoplexy(stroke),epilepsy

9、(epilepsy),angioneurotic headache (headache)and tonic headache(headache).12 5、内分泌系统心身疾病：、内分泌系统心身疾病：糖尿病糖尿病(消渴消渴)、甲亢、甲亢(瘿病瘿病)、肥胖病肥胖病(痰病痰病)、尿崩症、尿崩症(消渴消渴)、心因性多饮心因性多饮(消渴消渴)等。等。Psychosomatic diseases in the endocrine system include diabetes (diabetes),hyperthyroidism(goiter),obesity(phlegm syndrome),diabe

10、tes insipidus(diabetes),and psychogenic excessive drink of water(diabetes).13 6、泌尿生殖系统心身疾病：、泌尿生殖系统心身疾病：前列腺炎前列腺炎(白浊白浊)，过敏性膀胱炎，过敏性膀胱炎(淋症淋症)、尿道综合症尿道综合症(淋症淋症)、原发性性功能障碍、原发性性功能障碍(阳阳痿、早泄痿、早泄)等等 Psychosomatic diseases in the urogenital system include prostatitis (gonorrhea),allergic cystitis(stranguria),ure

11、thral syndrome(stranguria)and primary sexual disorder(impotence and premature ejaculation).14 7、骨骼肌肉系统心身疾病：、骨骼肌肉系统心身疾病：类风湿类风湿(痹证痹证)、全身肌肉痛、全身肌肉痛(痹证痹证)、书写痉挛书写痉挛(振颤振颤)、局部性肌痉挛、局部性肌痉挛(振颤振颤)等。等。Psychosomatic diseases in the skeletal and muscular systems include rheumatoid disease(arthralgia syndrome),pain

12、 in muscles throughout the body(arthralgia syndrome),writing spasm(tremor)and local muscular spasm(tremor).15 8、外科系统心身疾病：、外科系统心身疾病：包括腹部手术不适综合证包括腹部手术不适综合证(腹痛腹痛)、肠粘连症肠粘连症(便秘便秘)，等。，等。Psychosomatic diseases in the surgical department include uncomfortable syndrome of abdominal operation(abdominal pain)a

13、nd intestinal adhesion(constipation).16 9、妇产科心身疾病：、妇产科心身疾病：包括痛经包括痛经(痛经痛经)、闭经、闭经(经闭经闭)、月经不调、月经不调(月经月经先期、后期、先后不定先期、后期、先后不定)、功能性子宫出血、功能性子宫出血(崩崩漏漏)、更年期经前后诸症、更年期经前后诸症)、不孕症、不孕症(不孕不孕)Psychosomatic in the department ofgynecology andobstetricsincludedysmenorrhea(dysmenorrhea),amenia(amenia),irregular menstru

14、ation(advanced ordelayedenstruation),dysfunctional uterine bleeding(metrorrhagiaandmetrostaxis),menopausalsyndrome(diseasesaroundmenopause)and infertility(infertility).17 10、儿科心身疾病：、儿科心身疾病：神经性厌食症神经性厌食症(厌食厌食)、遗尿症、遗尿症(遗尿遗尿)、腹痛腹痛(腹痛腹痛)、头痛、头痛(头痛头痛)等。等。Psychosomatic diseases in the department of pediatri

15、cs include nervous anorexia(anorexia),enuresis(enuresis),abdominal pain (abdominal pain)and headache(headache).18 11、皮肤科心身疾病：、皮肤科心身疾病：湿疹湿疹(湿毒疮湿毒疮)、牛皮癣、牛皮癣(白疮白疮)、痤疮、痤疮(粉刺粉刺)、斑秃斑秃(油风油风)、慢性麻疹、慢性麻疹(风疹块风疹块)、多汗症、多汗症(汗汗证证)、皮肤瘙痒症、皮肤瘙痒症(风搔痒风搔痒)等。等。Psychosomatic diseases in the department of dermatology inclu

16、de eczema(noxious dampness),psoriasis,acne(acne),alopecia areata(alopecia areata),chronic urticaria(rubella),hyperhidrosis (sweating syndrome)and cutaneous pruritus(pruritus cutis).19 12、眼科心身疾病：、眼科心身疾病：原发性青光眼原发性青光眼(五风内障五风内障)、中心性视网膜炎、中心性视网膜炎(视惑视惑)、飞蚊症、飞蚊症(云雾移晴云雾移晴)、白内障、白内障(园翳内园翳内障障)、眼睛癔症、眼睛癔症(暴盲暴盲)等等

17、 Psychosomatic diseases in the department of ophthalmology include primary glaucoma(glaucoma),central choroido-retiritis (blurring vision),flying mosquito disease(vitreous opacity),cataract (cataract)and ocular hysteria(sudden loss of vision).20 13、耳鼻喉科心身疾病：、耳鼻喉科心身疾病：心因性耳聋心因性耳聋(耳聋耳聋)、美尼尔氏征、美尼尔氏征(眩晕眩

18、晕)、失音失音(喉喑喉喑)、过敏性鼻炎、过敏性鼻炎(鼻鼽鼻鼽)等。等。Psychosomatic diseases in the department of otolaryngology include psychogenic deafness(deafness),Menieres disease (dizziness),aphonia(aphonia due to throat disease)and allergic rhinitis(allergic rhinitis).21 14、口腔科心身疾病：、口腔科心身疾病：口臭口臭(口臭口臭)、口腔溃疡、口腔溃疡(口疮口疮)、特发性舌痛特发性舌

19、痛(舌痛舌痛)、心因性牙痛、心因性牙痛(牙痛牙痛)等。等。Psychosomatic diseases in the department of stomatology include ozostomia(ozostomia),stomatocace(aphthae),idiopathic glossalgia(glossalgia),psychogenic toothache(toothache).22 15、肿瘤科心身疾病：、肿瘤科心身疾病：胃癌胃癌(积聚积聚)、肝癌、肝癌(胁痛胁痛)肠癌肠癌(便血便血)、食道癌食道癌(噎嗝噎嗝)等。等。Psychosomatic diseases in

20、the department of tumor include carcinoma of stomach(abdominal mass),liver cancer(hypochondriac pain),intestinal cancer(hemafecia)and carcinoma of esophagus (dysphagia).2316.心身性亚健康Sub-Health24 应对心身疾病的挑战是世界医学应对心身疾病的挑战是世界医学的共同责任，的共同责任，1977年美国提出医学模年美国提出医学模式转变，但至今没有形成完整的理论式转变，但至今没有形成完整的理论和方法，没有实现心身整合的目标

21、。和方法，没有实现心身整合的目标。It is our resposibility to cope with psychosomatic diseases.However since 1977 changing the medicine model was emeraged in the US,there is not a complete theory and clinical method yet.25 19901990年去日本九州大学医学部向国际心年去日本九州大学医学部向国际心身医学会理事长池见酉次郎教授学习身医学会理事长池见酉次郎教授学习。2619961996年去日本九州大学医学部心疗内

22、科，年去日本九州大学医学部心疗内科，进修心身医学。现任亚洲心身医学会会长进修心身医学。现任亚洲心身医学会会长久保千春教授久保千春教授。2728 存在决定意识，需求决定发展，防存在决定意识，需求决定发展，防治心身疾病成为医学发展的方向，压力治心身疾病成为医学发展的方向，压力性疾病即心身疾病越来越多，超过以往性疾病即心身疾病越来越多，超过以往任何时期。任何时期。Demand determines development.Demand determines development.The prevention and cure of The prevention and cure of psycho

23、somatic diseases is the new psychosomatic diseases is the new direction of medicine.direction of medicine.中医学的创新与发展中医学的创新与发展29二、中医心身医学理论与临床二、中医心身医学理论与临床2.The theory and clinical research of TCM Psychosomatic Medicine3031 第一个时代第一个时代春秋战国时期春秋战国时期 The first stage-Spring and Autumn The first stage-Spring

24、 and Autumn and Warring States periods of China and Warring States periods of China(770 BC-221 BC)(770 BC-221 BC)精气学说、阴阳学说、五行学精气学说、阴阳学说、五行学说、脏象学说、以及病因病机，说、脏象学说、以及病因病机，诊断治疗，预防养生等各个方诊断治疗，预防养生等各个方面。面。黄帝内经黄帝内经32 第二个时代第二个时代 东汉时期东汉时期 The second stage-Eastern The second stage-Eastern Han Dynasty(25AD-220AD

25、)Han Dynasty(25AD-220AD)三阴三阳的伤寒病六经辩证三阴三阳的伤寒病六经辩证 经方派经方派 伤寒论伤寒论33第三个时代第三个时代金元时期金元时期The third stage-Jin and Yuan The third stage-Jin and Yuan Dynasty(1115AD-1368AD)Dynasty(1115AD-1368AD)刘完素刘完素 张子和张子和 李东垣李东垣 朱丹溪朱丹溪 寒凉寒凉 攻下攻下 补土补土 滋阴滋阴金元四大家金元四大家34第四个时代第四个时代清代清代The fourth stage-Qing Dynasty The fourth st

26、age-Qing Dynasty(1644-1911AD)(1644-1911AD)叶天士叶天士 吴鞠通吴鞠通 等等温病卫气营血辩证和三焦辩证温病卫气营血辩证和三焦辩证 温热论温热论35The fifth stage-Psychosomatic Medicine心身医学的时代心身医学的时代第五个时代第五个时代36 (2)Research on Etiology and Pathogenesis of TCM psychosomatic medicine37 “形神合一论形神合一论”“”“天人合一天人合一论论”“”“脏腑相关论脏腑相关论”“”“阴阳阴阳五行学说五行学说”。“The theory

27、on combination of physique and mentality i n t o o n e”,“t h e t h e o r y o n correspondence between man and universe”,“the theory on relations between zang and fu”and“the theory on yin-yang and five elements”38“主明则下安主明则下安，主不明则十二官危，主不明则十二官危，使道闭塞不通，形乃大伤使道闭塞不通，形乃大伤”“”“悲哀愁忧悲哀愁忧则心动，心动则五脏六腑皆摇则心动，心动则五脏六腑

28、皆摇”“”“精神精神内伤，身内伤，身必败亡必败亡”精辟地阐述了心理精辟地阐述了心理对生理的影响对生理的影响.“Mentality in order makes physique healthy Mentality in disorder makes twelve organs sick,tracts obstructed and physique seriously damaged.”“Sadness and depression make the heart disturbed,affecting all internal organs.”39“人之有生也，有阴有阳，有短有长，人之有生也，有

29、阴有阳，有短有长，有柔有刚有柔有刚”。中医的心理生理具有阴阳。中医的心理生理具有阴阳刚柔对立统一的特点刚柔对立统一的特点,归纳为归纳为“中医刚中医刚柔心身论柔心身论”(刚柔心理生理学说刚柔心理生理学说)。“People by birth have yin and yang,short and long,flexibilityandrigidity.”Therefore,TCM psychophysiology is characterized by the unity of opposites between yin and yang and between flexibility and r

30、igidity.The authors sum it up as“the flexible-rigid theory on TCM psychosomatic medicine”(the flexible-rigid doctrine on psychophysiology).40关于病因关于病因内经内经的正的正(内因内因)，邪，邪(外外因因)学说与现代心身医学认识一致。内学说与现代心身医学认识一致。内因有先天禀赋、气质、体质。外因有因有先天禀赋、气质、体质。外因有七情、六淫和饮食劳逸等。是心理、七情、六淫和饮食劳逸等。是心理、社会、生物、生活方式、行为等各种社会、生物、生活方式、行为等各种应

31、激因素。应激因素。Neijing is identical to modern psychosomatic medicine in the theory on internalandexternalfactors.Internalfactorsincludecongenitalendowment,temperament and physique.External factors include seven emotions,six climatic conditions,diet,labor and rest.41 调查内因可以找出心理素质和生理调查内因可以找出心理素质和生理素质的虚弱所在，即

32、正气虚的表现。调素质的虚弱所在，即正气虚的表现。调查外因则可找出心理、社会、生物、行查外因则可找出心理、社会、生物、行为诸种致病因素，即邪气实的表现。为诸种致病因素，即邪气实的表现。Investigation into internal factors can find what are feeble in psychological and physiological quality,which is manifested in deficiency of vital qi.Investigation into external factors can find disease-causin

33、g factors of psychology,sociality,biology and behavior,which is manifested in excess of pathogen.42If the patient was noble in the past and is now humble,although he had not attacked by the evil,he has disease produced from the interior.If he was rich in the past and is now poor that causes the dise

34、ases.凡诊病者，必问尝贵后贱，虽不凡诊病者，必问尝贵后贱，虽不中邪，病从内生，名曰脱营中邪，病从内生，名曰脱营INTERNAL CLASSIC43 Anger injuries liver,joy injuries heart,grief injuries lung,thinking injuries spleen and fear injuries kidney Internal classic怒伤肝怒伤肝、喜伤心、思伤脾、忧伤肺、喜伤心、思伤脾、忧伤肺、恐伤肾恐伤肾444546In the treatment of psychosomatic diseases,TCM always s

35、tresses “psychological treatment before physiological treatment”.The authors have for more than a decade summarized TCM methods for the treatment of psychosomatic diseases as of 9 types.(九九宝合璧宝合璧)474 4、心身疾病的刚柔辩证、心身疾病的刚柔辩证（4）Rigid-Gental Differentiation of Psychosomatic diseases 根据国内外的资料和自己的临床实践总结如下：

36、48 发病后首先伤肝，波及心、脾、肺，日久及肾。初期多为肝脾同病，肝心同病，肝肺同病，后期多为肝肾阴虚或肝脾肾的阳虚。末期阴竭、阳亡、阴阳离绝而终。In early stage,the diseases are mainly at both liver and spleen,both liver and heart,or both liver and lung.In late stage,the diseases are mainly manifested in yin-deficiency of the liver and kidney or yang-deficiency of the l

37、iver,spleen and kidney.In the end,the patient dies of yin-failure,yang-vanish and complete separation of yin from yang.49 病性为刚柔不能相济，而致病性为刚柔不能相济，而致疏泄失职，气滞血瘀，痰阻湿疏泄失职，气滞血瘀，痰阻湿困或气逆化火，火热伤阴，升困或气逆化火，火热伤阴，升降失司，日久由实转虚，脾虚降失司，日久由实转虚，脾虚肝郁或肾虚肝旺，极少纯虚证。肝郁或肾虚肝旺，极少纯虚证。（看下张英文）（看下张英文）50The nature of illness belongs to

38、 flexibility and rigidity unable to supplement each other,causing abnormal flow of qi,qi stagnation,blood stasis,obstruction of phlegm,retention of dampness,fire due to adverse flow of qi,impairment of yin due to fire,and disorder in ascension and descension.Lingering illness will transform from exc

39、ess to deficiency syndrome with deficiency of the spleen,stagnation of the liver-qi or deficiency of the kidney and excess of the liver-fire.Very few patients suffer from deficiency syndrome.51 心身疾病经过及时合理的治疗，多有心身疾病经过及时合理的治疗，多有较好的疗效，但容易因情志因素复发。较好的疗效，但容易因情志因素复发。Fairly good curative effects can be achi

40、eved in most patients with psychosomatic diseases through reasonable and timely medical treatment.However,these diseases easily recur due to emotional factors.52少数患者因治疗不当，可由实转虚，最少数患者因治疗不当，可由实转虚，最后阴亡或阳亡而终。另有少数患者可因后阴亡或阳亡而终。另有少数患者可因剧烈的情志刺激、气血暴逆或气血暴脱，剧烈的情志刺激、气血暴逆或气血暴脱，精去神亡。精去神亡。Patients with improper tr

41、eatment can transform from excess to deficiency and will finally die of yin-vanish or yang-vanish.Other patients could die of suddenly adverse flow of qi and blood or sudden collapse of qi and blood due to violent emotional stimulation.53心身疾病刚柔辨证论治心身疾病刚柔辨证论治心理社会压力心理社会压力 情志过激情志过激伤肝伤肝刚刚 证证柔柔 证证病机病机素体性

42、急阳刚疏泄太过肝旺成刚证素体性急阳刚疏泄太过肝旺成刚证实实证证肝气上逆肝气上逆抑肝降逆抑肝降逆肝火上炎肝火上炎泻肝降火泻肝降火心肝火旺心肝火旺泻肝清心泻肝清心心肝火旺痰瘀互结心肝火旺痰瘀互结泻肝清心化痰活血泻肝清心化痰活血虚虚证证心肝阴虚心肝阴虚柔肝养心柔肝养心肝肾阴虚肝阳上亢肝肾阴虚肝阳上亢滋阴平肝潜阳滋阴平肝潜阳肝肾阴虚风动肝肾阴虚风动滋补肝肾熄风滋补肝肾熄风阴损及阳阴损及阳滋阴助阳滋阴助阳结局结局阴亡阳亡阴亡阳亡素体性缓阴柔疏泄不及成柔证素体性缓阴柔疏泄不及成柔证肝郁气滞肝郁气滞疏肝理气疏肝理气肝郁血瘀肝郁血瘀疏肝活血疏肝活血肝郁脾困肝郁脾困疏肝理脾疏肝理脾肝郁痰湿阻肺肝郁痰湿阻肺疏肝化

43、痰理肺疏肝化痰理肺肝郁脾虚肝郁脾虚疏肝健脾疏肝健脾心肝气虚心肝气虚补肝养心补肝养心脾肾阳虚脾肾阳虚温补脾肾温补脾肾阳损及阴阳损及阴补阳助阴补阳助阴阳亡阴亡阳亡阴亡54心身疾病刚证柔证辩证论治心身疾病刚证柔证辩证论治心理社会压力、情志刺激心理社会压力、情志刺激实证素体性急阳刚疏泄太过肝旺一刚证刚证肝气上逆一抑肝降逆肝火上炎一泻肝降火心肝火旺一泻肝清心心肝火旺痰瘀互结一泻肝清心化痰活血素体性缓阴柔疏泄不及一肝郁一柔证柔证肝郁气滞一疏肝理气肝郁血瘀疏肝活血肝郁脾困一疏肝理脾肝郁痰湿阻肺一疏肝理肺化痰虚证心肝阴虚柔肝养心肝肾阴虚肝阳上亢滋阴平肝潜阳肝肾阴虚风动滋补肝肾熄风阴损及阳滋阴助阳肝郁脾虚一疏肝

44、健脾心肝气虚一补肝养心脾肾阳虚温补脾肾阳损及阴一补阳助阴结结局局阴亡阳亡阳亡阴亡55There are 2 classes,4 items,16 families in differentiation of syndromes according to the Rigid-Gental theory.562 classes are:57肝气上逆肝气上逆肝火上炎肝火上炎心肝火旺心肝火旺心肝火旺痰瘀互结心肝火旺痰瘀互结58肝郁气滞肝郁气滞肝郁血瘀肝郁血瘀肝郁脾困肝郁脾困肝郁痰湿阻肺肝郁痰湿阻肺59心肝阴虚心肝阴虚肝肾阴虚肝阳上亢肝肾阴虚肝阳上亢肝肾阴虚风动肝肾阴虚风动阴损及阳阴损及阳60 Stas

45、is of liver and insufficient of spleen 肝郁脾虚肝郁脾虚 Insufficient Qi of heart and liver 心肝气虚心肝气虚 Insufficient Yang of spleen and kidney 脾肾阳虚脾肾阳虚 Insufficient Yang result in insufficient Yin 阳损及阴阳损及阴61irritated spirit易怒易怒 tired spirit易疲易疲 red complexion面红面红 sallow complexion面白面白 Obesity肥胖肥胖Emaciation瘦弱瘦弱t

46、ongue coating is yellow苔黄苔黄tongue coating is white苔白苔白Halitosis口臭口臭 fishy smell口腥口腥 62Edgy急躁急躁 Gentle温和温和 Impatient无耐心无耐心Patient耐心耐心speak loudly&quickly声高语快声高语快speak softly&slowly声柔语慢声柔语慢Active活跃活跃Quiet安静安静Easily express emotion善于表达感情 Hardly express emotion不易表达感情 63 心身疾病的中医诊断，继承传统的四心身疾病的中医诊断，继承传统的四诊

47、，辨病和辨证，再吸收现代心身医学诊，辨病和辨证，再吸收现代心身医学的心理诊断和躯体诊断两部分内容。躯的心理诊断和躯体诊断两部分内容。躯体诊断与一般西医诊断相同。为中医心体诊断与一般西医诊断相同。为中医心身疾病的疗建立客观依据。身疾病的疗建立客观依据。On diagnosis of psychosomatic diseases in TCM,four traditional diagnoses,differentiation of diseases and syndromes should be inherited,and psychological and physiological diag

48、noses in modern psychosomatic medicine should be absorbed.TCM is identical to Western medicine in physiological diagnosis.645 5、病、病 例例 Case Report65Case Report Mr.Han,49y 男，男，49岁岁 Complaint:chest pain and tightness for 3 days 主诉：胸憋胸痛主诉：胸憋胸痛3天天66History:he complained chest pain and tightness for 3 da

49、ys and felt gradually severe because of nervous.He went to a hospitals emergency department and was not excluded of cardiac infarct by ECG.But later coronary arteriography showed normal and no evidence of infarct.工作紧张的人、症状不断加剧、急诊住院、冠状造影排工作紧张的人、症状不断加剧、急诊住院、冠状造影排除心梗除心梗病病 例例67 Treatment to symptoms was

50、 not effective.The doctor there referred him to our traditional Chinese medicine hospital.西医对症治疗无效推荐来我科看病西医对症治疗无效推荐来我科看病68 Except for the above symptoms,the patient also complained:Shortness of breath,abdominal distention,chest palpitation,poor appetite,and depression.EEG&brain atlas(BA)is abnormal.

51、气短、心慌、食欲减少、情绪低落气短、心慌、食欲减少、情绪低落 心电图、脑电地形图异常心电图、脑电地形图异常 69 西医诊断为心脏神经症西医诊断为心脏神经症Preliminary diagnosis of west Medicine:neurocardiac syndrome.70His Symptoms by TCM症状症状 Tired spiritSallow complexionQuietPatientTongue coating is white Diagnosis of TCM(Step 1)诊断诊断71His Symptoms by TCM 症状症状Diagnosis of TCM(

52、Step 2)诊断诊断 Red tongueChest pain and tightnessAbdominal distention72His Symptoms by TCMDiagnosis of TCM(Step 3)Tongue with purple spotsThe pain point is fixed证候证候症状症状73Diagnosis of TCM(Step 3)诊断诊断Treatment of TCM 治疗治疗Xufu Zhuyu Decoction74ResultOne month laterAll symptoms disappeared.ECG:normalEEG&B

53、A:normal治疗一个月之后，治疗一个月之后，症状消失，心、脑电图正常症状消失，心、脑电图正常75治疗治疗前前Before治疗后治疗后After76Hundreds of Successful Cases Cholecystitis 胆囊炎胆囊炎 Angina pectoris 冠心病冠心病 Neurogenicheadache神经性头痛神经性头痛 Cardiacarrhythmia心律失常心律失常 这样的病例有数百例这样的病例有数百例77The Number of Outpatients门诊量门诊量 800-900 personstimes/month每月每月 10,000 persons

54、times/year每年每年78近年近年处方处方病例病例79中医心身医学优于西医中医心身医学优于西医TCM compares with Western Medicine1 1、方法多、方法多 More methodsMore methods2 2、效果好、效果好 Better effectBetter effect4 4、节省医药费、节省医药费 Less expenseLess expense80研制了治疗冠心病的中药心身宝胶囊和心身静胶囊，治疗胆囊炎的胆胀疏和胆胀宁免煎冲剂，临床取得了显著的疗效，欢迎企业家合作开发。The new herb to treat Cholecystitis and Angina pectoris.81中国中医科学院广安门医院中国中医科学院广安门医院中医心身医学科中医心身医学科赵志付赵志付谢谢诸位谢谢诸位Thank You!