| 引用本文:李贞贞1，孙文军2，唐启盛2.基于张锡纯的癫狂理论探讨双相情感障碍的病机[J].世界中医药,2021,(08):. |
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| 基于张锡纯的癫狂理论探讨双相情感障碍的病机 |
| Discussion on Pathogenesis of Bipolar Affective Disorder Based on Demented Theory of ZHANG Xichun |
| 投稿时间：2020-07-09 |
| DOI：10.3969/j.issn.1673-7202.2021.08.014 |
| 中文关键词: 双相情感障碍 张锡纯 癫狂 动态病机 转化 痰火 郁证 狂证 |
| English Keywords:Bipolar affective disorder ZHANG Xichun Dementia and mania Dynamic pathogenesis Mutual transformation Pyrophlegm Stagnation syndrome Manic syndrome |
| 基金项目:国家中医药行业专项（201507001-12）；北京藏医院藏药项目（2016ZYY-SY01）；中国民族医药学会项目（2019KYXM-M105-141）；北京中医药大学新奥基金项目(2017-XAJLJJ-021） |
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| 中文摘要: |
| 双相情感障碍是指既有躁狂发作又有抑郁发作的一类情感障碍性疾病，抑郁相与躁狂相之间常相互转化。双相情感障碍的抑郁相和躁狂相分别属于中医“癫证”“郁证”与“狂证”的范畴，同时二者在病机上也具有共同的特征和相互转化的规律。张锡纯在论述心脑相通理论的基础上提出了癫狂发病及癫与狂转化的痰火病机，认为情志不遂、气郁化火是癫狂的始动因素，痰火瘀塞心脑相通之窍路是癫狂的核心病机，痰火的郁积与外散是癫狂转化的关键机转。现尝试从痰火的角度出发来分析双相情感障碍的动态病机，探讨抑郁相与躁狂相转化的病机演变规律，为临床治疗本病提供辨证思路。 |
| English Summary: |
| Bipolar affective disorder refers to a kind of affective disorder with manic episode and depressive episode.The depressive phase and manic phase often transform each other.The depressive phase and manic phase of bipolar affective disorder belong to the categories of “dementia syndrome”，“depressive syndrome” and “mania syndrome” in traditional Chinese medicine respectively.Meanwhile，the 2 also have common characteristics and mutual transformation rules in pathogenesis.On the basis of discussing the theory of heart-brain communication，ZHANG Xichun proposed the theory of phlegm-fire in the pathogenesis of dementia and mania and the transformation of dementia and mania.He believed that emotional failure and qi stagnation transforming in to fire in the body were the initial factors of dementia and mania，phlegm-fire stasis blocking the heart-brain communication was the core pathogenesis of dementia and mania，the stagnation and dispersion of phlegm-fire were the key mechanisms of transformation of dementia and mania.This paper attempts to analyze the dynamic pathogenesis of bipolar affective disorder from the perspective of phlegm-fire，discuss the pathogenesis evolution law of the transformation between depression and mania，providing dialectical thinking for clinical treatment of this disease. |
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