中醫(yī)心身醫(yī)學(xué)——心身疾病的剛?cè)徂q證

1、1中醫(yī)心身醫(yī)學(xué)中醫(yī)心身醫(yī)學(xué)心身疾病的剛?cè)徂q證心身疾病的剛?cè)徂q證2 一、應(yīng)對(duì)心身疾病的挑戰(zhàn)一、應(yīng)對(duì)心身疾病的挑戰(zhàn) 1、Coping with psychosomatic diseases 二、中醫(yī)心身醫(yī)學(xué)理論與臨二、中醫(yī)心身醫(yī)學(xué)理論與臨床床 2、The theory and clinical research of TCM Psychosomatic Medicine3一、應(yīng)對(duì)心身疾病的挑戰(zhàn)一、應(yīng)對(duì)心身疾病的挑戰(zhàn)1.Coping with psychosomatic diseases4 隨著世界經(jīng)濟(jì)的發(fā)展、社會(huì)的隨著世界經(jīng)濟(jì)的發(fā)展、社會(huì)的進(jìn)步和科學(xué)的日新月異，人類的疾進(jìn)步和科學(xué)的日新月異，人類的

2、疾病譜和死亡譜發(fā)生了根本的轉(zhuǎn)變。病譜和死亡譜發(fā)生了根本的轉(zhuǎn)變。Disease spectrum and the cause of death have changed dramatically 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 由過去的傳染病和營養(yǎng)不良由過去的傳染

3、病和營養(yǎng)不良為主，轉(zhuǎn)化為由心理社會(huì)因素生為主，轉(zhuǎn)化為由心理社會(huì)因素生活行為等因素引起的心身疾病為活行為等因素引起的心身疾病為主主.醫(yī)學(xué)模式已由生物醫(yī)學(xué)模式醫(yī)學(xué)模式已由生物醫(yī)學(xué)模式向生物向生物心理心理社會(huì)醫(yī)學(xué)模式轉(zhuǎn)社會(huì)醫(yī)學(xué)模式轉(zhuǎn)化?；?。6 中國也進(jìn)入快速發(fā)展時(shí)期，社會(huì)轉(zhuǎn)型，市場經(jīng)濟(jì)，競爭加劇，人際關(guān)系復(fù)雜，情緒壓力增大。 2121世紀(jì)是一個(gè)快速多變的，充滿了壓力與挑戰(zhàn)的時(shí)代 21st century is a time full of rapid changes, pressure and challenges. 7Psychosomatic Diseases in ChinaThe Healt

4、hy15%The Sub-healthy70%Others6%其他15%Psychosomatics9%The ill亞健康健康疾病心身疾病其他8 1、消化系統(tǒng)心身疾?。何负褪改c潰瘍(胃痛)、慢性胃炎(胃痞)、胃神經(jīng)癥(胃脹)、潰瘍性結(jié)腸炎(泄瀉、痢疾)、腸神經(jīng)癥(泄瀉)、習(xí)慣性便秘(便秘)、慢性肝炎(脅痛)、慢性膽囊炎(膽脹)、等。 Psychosomatic diseases in the digestive system include gastric and duodenal ulcer (stomachache), chronic gastritis (mass in the s

5、tomach), gastric neurosis (distension of the stomach), ulcerative colon (diarrhea and dysentery) 9 2、心血管系統(tǒng)心身疾?。涸l(fā)性高血壓病(眩暈)、原發(fā)性低血壓病(眩暈)、冠心病(胸痹)、心律失常(心悸)、心臟神經(jīng)癥(胸痹)、雷諾氏癥(厥證)、受體高敏癥(心悸)、心因性暈厥(厥癥)等。 Psychosomatic diseases in the cardiovascular system include primary hypertension (dizziness), essential hyp

6、otension (dizziness), coronary heart disease (obstruction of qi in the chest)10 3、呼吸系統(tǒng)心身疾?。?支氣管哮喘(哮喘)、過度換氣綜合癥(喘證)、 神經(jīng)性咳嗽(肝咳)等。 Psychosomatic diseases in the respiratory system include bronchial asthma (asthma), hyperventilation syndrome (dyspnea). syndrome) and nervous cough (dry cough11 4、神經(jīng)系統(tǒng)心身疾?。?/p>

7、腦卒中(中風(fēng))、癲癇(癇證)、血管神經(jīng)性頭痛(頭痛)、緊張性頭痛(頭痛)等。Psychosomatic diseases in the nervous system include cerebral apoplexy (stroke), epilepsy (epilepsy), angioneurotic headache (headache) and tonic headache (headache).12 5、內(nèi)分泌系統(tǒng)心身疾?。?糖尿病(消渴)、甲亢(癭病)、 肥胖病(痰病)、尿崩癥(消渴)、 心因性多飲(消渴)等。Psychosomatic diseases in the endocr

8、ine system include diabetes (diabetes), hyperthyroidism (goiter), obesity (phlegm syndrome), diabetes insipidus (diabetes), and psychogenic excessive drink of water (diabetes).13 6、泌尿生殖系統(tǒng)心身疾?。呵傲邢傺?白濁)，過敏性膀胱炎(淋癥)、尿道綜合癥(淋癥)、原發(fā)性性功能障礙(陽痿、早泄)等 Psychosomatic diseases in the urogenital system include prost

9、atitis (gonorrhea), allergic cystitis (stranguria), urethral syndrome (stranguria) and primary sexual disorder (impotence and premature ejaculation).14 7、骨骼肌肉系統(tǒng)心身疾?。侯愶L(fēng)濕(痹證)、全身肌肉痛(痹證)、書寫痙攣(振顫)、局部性肌痙攣(振顫)等。 Psychosomatic diseases in the skeletal and muscular systems include rheumatoid disease (arthral

10、gia syndrome), pain in muscles throughout the body (arthralgia syndrome), writing spasm (tremor) and local muscular spasm (tremor). 15 8、外科系統(tǒng)心身疾?。?包括腹部手術(shù)不適綜合證(腹痛)、 腸粘連癥(便秘)，等。 Psychosomatic diseases in the surgical department include uncomfortable syndrome of abdominal operation (abdominal pain) and

11、 intestinal adhesion (constipation).16 9、婦產(chǎn)科心身疾?。喊ㄍ唇?jīng)(痛經(jīng))、閉經(jīng)(經(jīng)閉)、月經(jīng)不調(diào)(月經(jīng)先期、后期、先后不定)、功能性子宮出血(崩漏)、更年期經(jīng)前后諸癥)、不孕癥(不孕)Psychosomatic in the department ofgynecology andobstetricsincludedysmenorrhea(dysmenorrhea), amenia(amenia), irregular menstruation (advanced ordelayedenstruation),dysfunctional uterine b

12、leeding (metrorrhagiaandmetrostaxis), menopausalsyndrome(diseasesaroundmenopause) and infertility (infertility).17 10、兒科心身疾病：神經(jīng)性厭食癥(厭食)、遺尿癥(遺尿)、 腹痛(腹痛)、頭痛(頭痛)等。Psychosomatic diseases in the department of pediatrics include nervous anorexia (anorexia), enuresis (enuresis), abdominal pain (abdominal p

13、ain) and headache (headache).18 11、皮膚科心身疾病： 濕疹(濕毒瘡)、牛皮癬(白瘡)、痤瘡(粉刺)、斑禿(油風(fēng))、慢性麻疹(風(fēng)疹塊)、多汗癥(汗證)、皮膚瘙癢癥(風(fēng)搔癢)等。Psychosomatic diseases in the department of dermatology include eczema (noxious dampness), psoriasis, acne (acne), alopecia areata (alopecia areata), chronic urticaria (rubella), hyperhidrosis (sw

14、eating syndrome) and cutaneous pruritus (pruritus cutis).19 12、眼科心身疾?。涸l(fā)性青光眼(五風(fēng)內(nèi)障)、中心性視網(wǎng)膜炎(視惑)、飛蚊癥(云霧移晴)、白內(nèi)障(園翳內(nèi)障)、眼睛癔癥(暴盲)等 Psychosomatic diseases in the department of ophthalmology include primary glaucoma (glaucoma), central choroido-retiritis (blurring vision), flying mosquito disease (vitreous

15、opacity), cataract (cataract) and ocular hysteria (sudden loss of vision).20 13、耳鼻喉科心身疾?。?心因性耳聾(耳聾)、美尼爾氏征(眩暈)、 失音(喉喑)、過敏性鼻炎(鼻鼽)等。 Psychosomatic diseases in the department of otolaryngology include psychogenic deafness (deafness), Menieres disease (dizziness), aphonia (aphonia due to throat disease)

16、and allergic rhinitis (allergic rhinitis). 21 14、口腔科心身疾?。?口臭(口臭)、口腔潰瘍(口瘡)、 特發(fā)性舌痛(舌痛)、心因性牙痛(牙痛)等。 Psychosomatic diseases in the department of stomatology include ozostomia (ozostomia), stomatocace (aphthae), idiopathic glossalgia (glossalgia), psychogenic toothache (toothache). 22 15、腫瘤科心身疾?。何赴?積聚)、肝

17、癌(脅痛) 腸癌(便血)、 食道癌(噎嗝)等。 Psychosomatic diseases in the department of tumor include carcinoma of stomach (abdominal mass), liver cancer (hypochondriac pain), intestinal cancer (hemafecia) and carcinoma of esophagus (dysphagia).2316.心身性亞健康Sub-Health24 應(yīng)對(duì)心身疾病的挑戰(zhàn)是世界醫(yī)應(yīng)對(duì)心身疾病的挑戰(zhàn)是世界醫(yī)學(xué)的共同責(zé)任，學(xué)的共同責(zé)任，1977年美國提出醫(yī)年

18、美國提出醫(yī)學(xué)模式轉(zhuǎn)變，但至今沒有形成完整的學(xué)模式轉(zhuǎn)變，但至今沒有形成完整的理論和方法，沒有實(shí)現(xiàn)心身整合的目理論和方法，沒有實(shí)現(xiàn)心身整合的目標(biāo)。標(biāo)。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年去日本九州大學(xué)醫(yī)學(xué)部向國際心年去日本九州大學(xué)醫(yī)學(xué)部向國際

19、心身醫(yī)學(xué)會(huì)理事長池見酉次郎教授學(xué)習(xí)身醫(yī)學(xué)會(huì)理事長池見酉次郎教授學(xué)習(xí)。2619961996年去日本九州大學(xué)醫(yī)學(xué)部心療內(nèi)科，年去日本九州大學(xué)醫(yī)學(xué)部心療內(nèi)科，進(jìn)修心身醫(yī)學(xué)?，F(xiàn)任亞洲心身醫(yī)學(xué)會(huì)會(huì)進(jìn)修心身醫(yī)學(xué)?，F(xiàn)任亞洲心身醫(yī)學(xué)會(huì)會(huì)長久保千春教授長久保千春教授。27wisdom from TCMwisdom from TCM”. .28 存在決定意識(shí)，需求決定發(fā)展，防存在決定意識(shí)，需求決定發(fā)展，防治心身疾病成為醫(yī)學(xué)發(fā)展的方向，壓力治心身疾病成為醫(yī)學(xué)發(fā)展的方向，壓力性疾病即心身疾病越來越多，超過以往性疾病即心身疾病越來越多，超過以往任何時(shí)期。任何時(shí)期。 Demand determines developme

20、nt. Demand determines development. The prevention and cure of The prevention and cure of psychosomatic diseases is the new psychosomatic diseases is the new direction of medicine. direction of medicine. 中醫(yī)學(xué)的創(chuàng)新與發(fā)展中醫(yī)學(xué)的創(chuàng)新與發(fā)展29二、中醫(yī)心身醫(yī)學(xué)理論與臨床二、中醫(yī)心身醫(yī)學(xué)理論與臨床2.The theory and clinical research of TCM Psychosom

21、atic Medicine3031 第一個(gè)時(shí)代春秋戰(zhàn)國時(shí)期 The first stage-Spring and The first stage-Spring and Autumn and Warring States periods Autumn and Warring States periods of China (770 BC -221 BC)of China (770 BC -221 BC) 精氣學(xué)說、陰陽學(xué)說、五行學(xué)說、臟象學(xué)說、以及病因病機(jī)，診斷治療，預(yù)防養(yǎng)生等各個(gè)方面。 黃帝內(nèi)經(jīng)32 第二個(gè)時(shí)代 東漢時(shí)期 The second stage-Eastern The second

22、stage-Eastern Han Dynasty (25AD-220AD)Han Dynasty (25AD-220AD) 三陰三陽的傷寒病六經(jīng)辯證 經(jīng)方派 傷寒論33第三個(gè)時(shí)代金元時(shí)期The third stage-Jin and Yuan The third stage-Jin and Yuan Dynasty (1115AD-1368AD)Dynasty (1115AD-1368AD) 劉完素 張子和 李東垣 朱丹溪 寒涼 攻下 補(bǔ)土 滋陰金元四大家34第四個(gè)時(shí)代清代The fourth stage-Qing Dynasty The fourth stage-Qing Dynasty

23、(1644-1911AD)(1644-1911AD) 葉天士 吳鞠通 等溫病衛(wèi)氣營血辯證和三焦辯證 溫?zé)嵴?5The fifth stage-Psychosomatic Medicine心身醫(yī)學(xué)的時(shí)代第五個(gè)時(shí)代36 (2) Research on Etiology and Pathogenesis of TCM psychosomatic medicine37 “形神合一論形神合一論”“”“天人合一天人合一論論”“”“臟腑相關(guān)論臟腑相關(guān)論”“”“陰陽陰陽五行學(xué)說五行學(xué)說”?！癟he theory on combination of physique and mentality into one

24、”, “ t h e t h e o r y o n correspondence between man and universe”, “the theory on relations between z a n g a n d f u ” a n d “ t h e theory on yin-yang and five elements” 38“主明則下安主明則下安，主不明則十二官，主不明則十二官危，使道閉塞不通，形乃大傷危，使道閉塞不通，形乃大傷”“”“悲悲哀愁憂則心動(dòng)，心動(dòng)則五臟六腑皆哀愁憂則心動(dòng)，心動(dòng)則五臟六腑皆搖搖”“”“精神內(nèi)傷，身精神內(nèi)傷，身必?cái)⊥霰財(cái)⊥觥?精辟精辟地闡述了心

25、理對(duì)生理的影響地闡述了心理對(duì)生理的影響.“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，有陰有陽，有短有長，人之有生也，有陰有陽，有短有長，有柔有剛有柔有剛”。中醫(yī)的心理生理具有陰。中

26、醫(yī)的心理生理具有陰陽剛?cè)釋?duì)立統(tǒng)一的特點(diǎn)陽剛?cè)釋?duì)立統(tǒng)一的特點(diǎn), ,歸納為歸納為“中中醫(yī)剛?cè)嵝纳碚撫t(yī)剛?cè)嵝纳碚摗? (剛?cè)嵝睦砩韺W(xué)說剛?cè)嵝睦砩韺W(xué)說) )。 “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 rigidity. The authors s

27、um it up as “the flexible-rigid theory on TCM psychosomatic medicine” (the flexible-rigid doctrine on psychophysiology).40關(guān)于病因關(guān)于病因內(nèi)經(jīng)內(nèi)經(jīng)的正的正( (內(nèi)因內(nèi)因) )，邪，邪( (外因外因) )學(xué)說與現(xiàn)代心身醫(yī)學(xué)認(rèn)識(shí)一學(xué)說與現(xiàn)代心身醫(yī)學(xué)認(rèn)識(shí)一致。內(nèi)因有先天稟賦、氣質(zhì)、體質(zhì)。致。內(nèi)因有先天稟賦、氣質(zhì)、體質(zhì)。外因有七情、六淫和飲食勞逸等。外因有七情、六淫和飲食勞逸等。是心理、社會(huì)、生物、生活方式、是心理、社會(huì)、生物、生活方式、行為等各種應(yīng)激因素。行為等各種應(yīng)激因素。 N

28、eijing 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 調(diào)查內(nèi)因可以找出心理素質(zhì)和生調(diào)查內(nèi)因可以找出心理素質(zhì)和生理素質(zhì)的虛弱所在，即正氣虛的表現(xiàn)。

29、理素質(zhì)的虛弱所在，即正氣虛的表現(xiàn)。調(diào)查外因則可找出心理、社會(huì)、生物、調(diào)查外因則可找出心理、社會(huì)、生物、行為諸種致病因素，即邪氣實(shí)的表現(xiàn)。行為諸種致病因素，即邪氣實(shí)的表現(xiàn)。 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-causing fa

30、ctors 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 di

31、seases.凡診病者，必問嘗貴后賤，雖不中邪，病從內(nèi)生，名曰脫營INTERNAL CLASSIC43 Anger injuries liver, joy injuries heart, grief injuries lung, thinking injuries spleen and fear injuries kidney Internal classic怒傷肝 、喜傷心、思傷脾、憂傷肺、 恐傷腎444546In the treatment of psychosomatic diseases, TCM always stresses “psychological treatment bef

32、ore physiological treatment”. The authors have for more than a decade summarized TCM methods for the treatment of psychosomatic diseases as of 9 types.(九寶合璧)474 4、心身疾病的剛?cè)徂q證、心身疾病的剛?cè)徂q證 （4） Rigid-Gental Differentiation of Psychosomatic diseases根據(jù)國內(nèi)外的資料和自己的臨床實(shí)踐總結(jié)如下：48 發(fā)病后首先傷肝，波及心、脾、發(fā)病后首先傷肝，波及心、脾、肺，日久及腎。

33、初期多為肝脾同病，肺，日久及腎。初期多為肝脾同病，肝心同病，肝肺同病，后期多為肝腎肝心同病，肝肺同病，后期多為肝腎陰虛或肝脾腎的陽虛。末期陰竭、陽陰虛或肝脾腎的陽虛。末期陰竭、陽亡、陰陽離絕而終。亡、陰陽離絕而終。 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

34、 and kidney or yang-deficiency of the liver, spleen and kidney. In the end, the patient dies of yin-failure, yang-vanish and complete separation of yin from yang.49 病性為剛?cè)岵荒芟酀?jì)，而病性為剛?cè)岵荒芟酀?jì)，而致疏泄失職，氣滯血瘀，痰阻致疏泄失職，氣滯血瘀，痰阻濕困或氣逆化火，火熱傷陰，濕困或氣逆化火，火熱傷陰，升降失司，日久由實(shí)轉(zhuǎn)虛，脾升降失司，日久由實(shí)轉(zhuǎn)虛，脾虛肝郁或腎虛肝旺，極少純虛虛肝郁或腎虛肝旺，極少純虛證。證。 （看下張

35、英文）（看下張英文）50The nature of illness belongs to 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

36、descension. Lingering illness will transform from excess 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心身疾病經(jīng)過及時(shí)合理的治療，多有心身疾病經(jīng)過及時(shí)合理的治療，多有較好的療效，但容易因情志因素復(fù)發(fā)。較好的

37、療效，但容易因情志因素復(fù)發(fā)。 Fairly good curative effects can be achieved in most patients with psychosomatic diseases through reasonable and timely medical treatment. However, these diseases easily recur due to emotional factors.52少數(shù)患者因治療不當(dāng)，可由實(shí)轉(zhuǎn)虛，少數(shù)患者因治療不當(dāng)，可由實(shí)轉(zhuǎn)虛，最后陰亡或陽亡而終。另有少數(shù)患者最后陰亡或陽亡而終。另有少數(shù)患者可因劇烈的情志刺激、氣血暴逆或氣可因

38、劇烈的情志刺激、氣血暴逆或氣血暴脫，精去神亡。血暴脫，精去神亡。 Patients with i m p r o p e r t r e a t m e n t c a n t r a n s f o r m f r o m e x c e s s t o 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 d u e t

39、o v i o l e n t e m o t i o n a l stimulation.53心身疾病剛?cè)岜孀C論治心身疾病剛?cè)岜孀C論治心理社會(huì)壓力心理社會(huì)壓力 情志過激情志過激傷肝傷肝剛剛 證證柔柔 證證病機(jī)病機(jī)素體性急陽剛疏泄太過肝旺成剛證素體性急陽剛疏泄太過肝旺成剛證實(shí)實(shí) 證證肝氣上逆肝氣上逆抑肝降逆抑肝降逆肝火上炎肝火上炎瀉肝降火瀉肝降火心肝火旺心肝火旺瀉肝清心瀉肝清心心肝火旺痰瘀互結(jié)心肝火旺痰瘀互結(jié)瀉肝清心化痰活血瀉肝清心化痰活血虛虛證證心肝陰虛心肝陰虛柔肝養(yǎng)心柔肝養(yǎng)心肝腎陰虛肝陽上亢肝腎陰虛肝陽上亢滋陰平肝潛陽滋陰平肝潛陽肝腎陰虛風(fēng)動(dòng)肝腎陰虛風(fēng)動(dòng)滋補(bǔ)肝腎熄風(fēng)滋補(bǔ)肝腎熄風(fēng)陰損及陽陰損

40、及陽滋陰助陽滋陰助陽結(jié)局結(jié)局陰亡陽亡陰亡陽亡素體性緩陰柔疏泄不及成柔證素體性緩陰柔疏泄不及成柔證肝郁氣滯肝郁氣滯疏肝理氣疏肝理氣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濕阻肺肝郁痰濕阻肺疏肝化痰理肺疏肝化痰理肺肝郁脾虛肝郁脾虛疏肝健脾疏肝健脾心肝氣虛心肝氣虛補(bǔ)肝養(yǎng)心補(bǔ)肝養(yǎng)心脾腎陽虛脾腎陽虛溫補(bǔ)脾腎溫補(bǔ)脾腎陽損及陰陽損及陰補(bǔ)陽助陰補(bǔ)陽助陰陽亡陰亡陽亡陰亡54心身疾病剛證柔證辯證論治心身疾病剛證柔證辯證論治心理社會(huì)壓力、情志刺激心理社會(huì)壓力、情志刺激實(shí)證素體性急陽剛疏泄太過肝旺一剛證肝氣上逆一抑肝降逆肝火上炎一瀉肝降火心肝火旺一瀉肝清心心肝火旺痰瘀互結(jié)一瀉肝清心化痰活

41、血素體性緩陰柔疏泄不及一肝郁一柔證肝郁氣滯一疏肝理氣肝郁血瘀疏肝活血肝郁脾困一疏肝理脾肝郁痰濕阻肺一疏肝理肺化痰虛證心肝陰虛柔肝養(yǎng)心肝腎陰虛肝陽上亢滋陰平肝潛陽肝腎陰虛風(fēng)動(dòng)滋補(bǔ)肝腎熄風(fēng)陰損及陽滋陰助陽肝郁脾虛一疏肝健脾心肝氣虛一補(bǔ)肝養(yǎng)心脾腎陽虛溫補(bǔ)脾腎陽損及陰一補(bǔ)陽助陰結(jié)局陰亡陽亡陽亡陰亡55There are 2 classes, 4 items, 16 families in differentiation of syndromes according to the Rigid-Gental theory.562 classes are: Rigid-deficiency SymptomG

42、ental-deficiency symptom 57肝氣上逆肝火上炎心肝火旺心肝火旺痰瘀互結(jié)58肝郁氣滯肝郁血瘀肝郁脾困肝郁痰濕阻肺59心肝陰虛肝腎陰虛肝陽上亢肝腎陰虛風(fēng)動(dòng)陰損及陽insufficient yang60Stasis of liver and insufficient of spleen 肝郁脾虛 Insufficient Qi of heart and liver 心肝氣虛 Insufficient Yang of spleen and kidney 脾腎陽虛 Insufficient Yang result in insufficient Yin 陽損及陰61irritat

43、ed spirit易怒易怒 tired spirit易疲易疲 red complexion面紅面紅 sallow complexion面白面白 Obesity肥胖肥胖Emaciation瘦弱瘦弱tongue coating is yellow苔黃苔黃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溫和溫和 Impatient無耐心無耐心Patient耐心耐心speak loudly & quickly聲高語快聲高語快speak softly & slowly聲柔語慢聲柔語慢Active活躍活躍Q

44、uiet安靜安靜Easily express emotion善于表達(dá)感情 Hardly express emotion不易表達(dá)感情 63 心身疾病的中醫(yī)診斷，繼承傳統(tǒng)的心身疾病的中醫(yī)診斷，繼承傳統(tǒng)的四診，辨病和辨證，再吸收現(xiàn)代心身四診，辨病和辨證，再吸收現(xiàn)代心身醫(yī)學(xué)的心理診斷和軀體診斷兩部分內(nèi)醫(yī)學(xué)的心理診斷和軀體診斷兩部分內(nèi)容。軀體診斷與一般西醫(yī)診斷相同。容。軀體診斷與一般西醫(yī)診斷相同。為中醫(yī)心身疾病的療建立客觀依據(jù)。為中醫(yī)心身疾病的療建立客觀依據(jù)。 On diagnosis of psychosomatic diseases in TCM, four traditional diagnose

45、s, differentiation of diseases and syndromes should be inherited, and psychological and physiological diagnoses 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，49歲Complaint: che

46、st pain and tightness for 3 days主訴：胸憋胸痛3天66History: he complained chest pain and tightness for 3 days 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 eviden

47、ce of infarct. 工作緊張的人、癥狀不斷加劇、急診住院、冠狀造影排除心梗病 例67Treatment to symptoms was not effective. The doctor there referred him to our traditional Chinese medicine hospital. 西醫(yī)對(duì)癥治療無效推薦來我科看病68Except for the above symptoms, the patient also complained: Shortness of breath, abdominal distention, chest palpitatio

48、n, poor appetite, and depression. EEG & brain atlas (BA) is abnormal. 氣短、心慌、食欲減少、情緒低落 心電圖、腦電地形圖異常 69 西醫(yī)診斷為心臟神經(jīng)癥Preliminary diagnosis of west Medicine: neurocardiac syndrome.70His Symptoms by TCM癥狀 Tired spiritSallow complexionQuietPatientTongue coating is white Diagnosis of TCM(Step 1) 診斷71His Sympt

49、oms by TCM 癥狀Diagnosis of TCM(Step 2)診斷 Red tongueChest pain and tightnessAbdominal distention72His Symptoms by TCMDiagnosis of TCM(Step 3)Tongue with purple spotsThe pain point is fixed證候癥狀73Diagnosis of TCM(Step 3)診斷Treatment of TCM 治療Xufu Zhuyu Decoction74ResultOne month laterAll symptoms disappe

50、ared.ECG: normalEEG & BA: normal治療一個(gè)月之后，癥狀消失，心、腦電圖正常75治療前Before治療后After76Hundreds of Successful CasesCholecystitis 膽囊炎Angina pectoris 冠心病Neurogenic headache神經(jīng)性頭痛 Cardiac arrhythmia 心律失常 這樣的病例有數(shù)百例77The Number of Outpatients門診量800-900 personstimes/month每月10,000 personstimes/year每年78近年處方病例79中醫(yī)心身醫(yī)學(xué)優(yōu)于西醫(yī)中

51、醫(yī)心身醫(yī)學(xué)優(yōu)于西醫(yī)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、節(jié)省醫(yī)藥費(fèi)、節(jié)省醫(yī)藥費(fèi) Less Less expenseexpense80研制了治療冠心病的中藥研制了治療冠心病的中藥心身寶心身寶膠囊和心身靜膠囊膠囊和心身靜膠囊，治療膽囊炎，治療膽囊炎的的膽脹疏和膽脹寧免煎沖劑膽脹疏和膽脹寧免煎沖劑，臨，臨床取得了顯著的療效，歡迎企業(yè)床取得了顯著的療效，歡迎企業(yè)家合作開發(fā)。家合作開發(fā)。The new herb to The new herb to treat Cholecystitis and treat Cholecystitis an