1. 上海中医药大学附属曙光医院,上海,200021
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蒋健. 郁证发微(五)——郁证疼痛论[J]. 上海中医药杂志, 2015,49(12):5-7.
JIANG Jian. Pain due to depression syndrome(Ⅴ)[J]. Shanghai Journal of Traditional Chinese Medicine, 2015,49(12):5-7.
情志不遂除可引起胁痛、脘痛外,还可引起心痛、胸痛、腹痛、腰痛、眉目痛甚至周身无处不痛;其病机除肝气郁结犯胃或气郁化火外,还与情志伤及心脾肾有关;疼痛的轻重变化可与心之躁寂有关。疼痛不仅与心理、精神因素互为因果,还具有共同的病理生理物质基础,可以是抑郁症的躯体症状。郁证疼痛的临床特征包括疼痛因情志波动而变化,具有功能性、多样性、广泛性、复发性、怪异性等特性,多表现为“不定疼痛”,从郁论治后可以缓解。郁证疼痛的病机包括但并不限于 “不通则痛”和“不荣则痛”。痛证可考虑从郁论治。
Not only hypochondriac pain and stomachache, but also cardiodynia,pectoralgia,abdominal pain,osphyalgia,ophthalmalgia,and even pantalgia can all be induced by depression. Apart from the stagnation of liver-qi,and stagnated qi transforming into fire,the pathogenesis of pain can also be connected to the dysfunction of heart,spleen,and kidney which was injured by bad emotion. The severity of pain is related to the activity of heart. Modern medicine proved that pain,psychological factors and pathophysiologic bases are cause-and-effect each other. Pain can be the somatic symptoms of depression. The clinical features of pain due to depression syndrome includes the fluctuation of emotion induced by pain; it possess the characteristics of functionality, variety, universality, relapsing, and peculiarity; it also manifests “the uncertain pain”; and it can be relieved after the antidepressant therapy. The pathogenesis of pain due to depression syndrome includes but not limits to the “pain induced by qi and blood stasis” as well as “pain induced by qi and blood without nourishment”. Treating from the aspect of depression can be considered in the pain treatment.
郁证疼痛从郁论治心理学
depression syndromepaintreating from the aspect of depressionpsychology
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