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(七)——郁证耳鸣论[J]. 上海中医药杂志, 2016,50(2):4-7.
JIANG Jian. Tinnitus due to depression syndrome(Ⅶ)[J]. Shanghai Journal of Traditional Chinese Medicine, 2016,50(2):4-7.
探讨郁证性耳鸣的病脉证治。认为对耳鸣的辨治不能僵执“肾开窍于耳”之教条,概从补肾论治。耳鸣可以是郁证的常见临床表现之一,抑郁、恚怒、忧思、焦虑、惊恐等情志变化皆可致生耳鸣。郁证性耳鸣一般具有郁证“直接的”临床表现证据(情志性疾病心理及精神神经系统方面的症状),更多具有郁证“间接的”临床表现证据(涉及多脏腑系统的“异彩纷呈”的全身症状),本质上是一种在耳鸣掩盖下的隐性郁证。现代医学病理生理学、心理学及中西医治疗学均佐证了郁证性耳鸣的客观存在。对屡治不愈的耳鸣可从郁证角度重新审视其脉证,从郁论治,或试探性地从郁论治,以提高临床疗效。
This paper explores the therapy and syndromes of tinnitus due to depression syndrome. It indicates that tinnitus cannot be restricted to the dogma of “the kidney opening into the ears”,and also cannot invigorate kidney totally. Tinnitus is a common manifestation of depression syndrome,ancient physicians had expounded it sufficiently. Depression,anger,anxiety,panic can all lead to tinnitus. Tinnitus due to depression syndrome has direct clinical evidences(emotional disorders’ mind and psychotic and neurologic symptoms),as well as indirect clinical evidences further(involved colorful constitutional symptoms). Tinnitus due to depression syndrome is a kind of masked depression syndrome which concealed by the tinnitus essentially. The objective existence of tinnitus due to depression syndrome has been proved by modern pathophysiology,psychology,and therapeutics of traditional and western medicine already. To improve the clinical curative effect,we should consider the intractable tinnitus again from the view of depression syndrome,and try to treat it from the aspect of depression syndrome.
郁证耳鸣临床特征从郁论治
depression syndrometinnitusclinical featurestreating from the aspect of depression
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