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上海中医药大学附属龙华医院(上海 200032)
吴月,女,博士研究生,主要从事脾胃病的中医基础与临床研究工作
袁建业,研究员,博士研究生导师; E-mail:yuanjianye@hotmail.com
收稿:2025-12-13,
纸质出版:2026-07-10
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Wu Yue,Mo Lian,He Youcheng,et al.Discussion on pathogenesis and treatment of cathartic colon and anxiety‑depression comorbidity from perspective of "disease‑induced depression" and "depression‑triggered disease"[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(7):25-31.
吴月,磨炼,何友成,等.从“因病致郁”“因郁致病”探讨泻药性结肠与焦虑抑郁共病的发病机制与治疗策略[J].上海中医药杂志,2026,60(7):25-31. DOI: 10.16305/j.1007-1334.2026.z20251213003.
Wu Yue,Mo Lian,He Youcheng,et al.Discussion on pathogenesis and treatment of cathartic colon and anxiety‑depression comorbidity from perspective of "disease‑induced depression" and "depression‑triggered disease"[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(7):25-31. DOI: 10.16305/j.1007-1334.2026.z20251213003.
从“因病致郁”(久病致郁、久药致郁)与“因郁致病”(气郁致病、血郁致病)双向路径,剖析泻药性结肠(CC)与焦虑抑郁共病病机的传变规律,并结合肠-脑轴失调、下丘脑-垂体-肾上腺轴激活、微生态失衡等现代医学机制,阐释其共病的科学内涵。基于“郁病同治”原则构建身心共调、分期论治的整体框架。分期治则:初期/活动期以调神疏肝、理气开郁为主,中期/迁延期注重活血化瘀、祛浊解毒,后期/虚损期侧重益气养阴、扶正固本;分证落实:对应常见肝郁气滞、瘀血阻络、心脾两虚及气阴两虚兼瘀等证候,形成证治方药。同时强调方药随证加减、针灸“调神”与“治肠”并举、心理行为干预等综合疗法的运用。
This paper analyzes the transmission patterns underlying the comorbidity of cathartic colon (CC) and anxiety and depression through the bidirectional pathways of "disease‑induced depression" (chronic illness or prolonged medication inducing depression) and "depression‑triggered disease" (qi or blood depression causing disease). It further elucidates the scientific connotation of this comorbidity by integrating modern medical mechanisms such as gut-brain axis dysfunction, hypothalamic-pituitary-adrenal axis activation, and microbial imbalance. Based on the principle of "simultaneous treatment of stagnation and disease," an integrated framework for mind-body regulation and stage-specific treatment is established. This framework is stage-led in treatment principle: the initial/active stage focuses on regulating the spirit, soothing the liver, and moving qi to resolve stagnation; the middle/prolonged stage emphasizes activating blood circulation, resolving stasis, and eliminating turbidity and toxins; and the late/deficiency stage prioritizes boosting qi, nourishing yin, and supporting healthy qi to consolidate the foundation. Treatment is syndrome-specified: corresponding to common syndromes such as liver qi stagnation, blood stasis obstructing the collaterals, heart-spleen deficiency, and qi-yin deficiency with blood stasis, a syndrome-specific treatment plan is formulated with corresponding formulas. Meanwhile, the application of comprehensive therapies is also emphasized, including modifying medicinal formulas according to clinical syndromes, combining acupuncture and moxibustion for "mind regulation" and "intestinal treatment", and implementing psychological and behavioral interventions.
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