1、1 一、應對心身疾病的挑戰(zhàn)一、應對心身疾病的挑戰(zhàn) 1、Coping with psychosomatic diseases 二、中醫(yī)心身醫(yī)學理論與臨床二、中醫(yī)心身醫(yī)學理論與臨床 2、The theory and clinical research of TCM Psychosomatic Medicine 2 一、應對心身疾病的挑戰(zhàn) 1.Coping with psychosomatic diseases 3 隨著世界經濟的發(fā)展、社會的進隨著世界經濟的發(fā)展、社會的進 步和科學的日新月異，人類的疾病譜步和科學的日新月異，人類的疾病譜 和死亡譜發(fā)生了根本的轉變。和死亡譜發(fā)生了根本的轉變。 Dise

2、ase 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. 4 由過去的傳染病和營養(yǎng)不良由過去的傳染病和營養(yǎng)不良 為主，轉化為由心理社會因素生為主，轉化為由心理社會因素

3、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)學模式已由生物醫(yī)學模式向醫(yī)學模式已由生物醫(yī)學模式向 生物生物心理心理社會醫(yī)學模式轉化。社會醫(yī)學模式轉化。 5 中國也進入快速發(fā)展時期，社會轉中國也進入快速發(fā)展時期，社會轉 型，市場經濟，競爭加劇，人際關系復型，市場經濟，競爭加劇，人際關系復 雜，情緒壓力增大。雜，情緒壓力增大。 2121世紀是一個快速多變的，充滿了世紀是一個快速多變的，充滿了 壓力與挑戰(zhàn)的時代壓力與挑戰(zhàn)的時代 21st century is a time full of rapid changes, pressure and challenges. 6 Ps

4、ychosomatic Diseases in China The Healthy 15% The Sub- healthy 70% Others 6% 其他 15% Psychosomatic s 9% The ill 亞亞 健健 康康 健 康 疾疾 病病 心身疾病 其 他 7 1、消化系統心身疾?。骸⑾到y心身疾?。?胃和十二指腸潰瘍胃和十二指腸潰瘍(胃痛胃痛)、慢性胃炎、慢性胃炎(胃痞胃痞)、 胃神經癥胃神經癥(胃脹胃脹)、潰瘍性結腸炎、潰瘍性結腸炎(泄瀉、痢疾泄瀉、痢疾)、 腸神經癥腸神經癥(泄瀉泄瀉)、習慣性便秘、習慣性便秘(便秘便秘)、慢性肝、慢性肝 炎炎(脅痛脅痛)、慢性膽囊炎

5、、慢性膽囊炎(膽脹膽脹)、等。、等。 Psychosomatic diseases in the digestive system include gastric and duodenal ulcer (stomachache), chronic gastritis (mass in the stomach), gastric neurosis (distension of the stomach), ulcerative colon (diarrhea and dysentery) 8 2、心血管系統心身疾?。?、心血管系統心身疾?。?原發(fā)性高血壓病原發(fā)性高血壓病(眩暈眩暈)、原發(fā)性低血壓病、

6、原發(fā)性低血壓病(眩暈眩暈)、 冠心病冠心病(胸痹胸痹)、心律失常、心律失常(心悸心悸)、心臟神經癥、心臟神經癥(胸胸 痹痹)、雷諾氏癥、雷諾氏癥(厥證厥證)、受體高敏癥受體高敏癥(心悸心悸)、 心因性暈厥心因性暈厥(厥癥厥癥)等。等。 Psychosomatic diseases in the cardiovascular system include primary hypertension (dizziness), essential hypotension (dizziness), coronary heart disease (obstruction of qi in the ches

7、t) 9 3、呼吸系統心身疾?。?、呼吸系統心身疾?。?支氣管哮喘支氣管哮喘(哮喘哮喘)、過度換氣綜合癥、過度換氣綜合癥(喘證喘證)、 神經性咳嗽神經性咳嗽(肝咳肝咳)等。等。 Psychosomatic diseases in the respiratory system include bronchial asthma (asthma), hyperventilation syndrome (dyspnea). syndrome) and nervous cough (dry cough 10 4、神經系統心身疾?。?、神經系統心身疾病： 腦卒中腦卒中(中風中風)、癲癇、癲癇(癇證癇證)、血管

8、神經性頭痛、血管神經性頭痛 (頭痛頭痛)、緊張性頭痛、緊張性頭痛(頭痛頭痛)等。等。 Psychosomatic diseases in the nervous system include cerebral apoplexy (stroke), epilepsy (epilepsy), angioneurotic headache (headache) and tonic headache (headache). 11 5、內分泌系統心身疾?。?、內分泌系統心身疾?。?糖尿病糖尿病(消渴消渴)、甲亢、甲亢(癭病癭病)、 肥胖病肥胖病(痰病痰病)、尿崩癥、尿崩癥(消渴消渴)、 心因性多飲心因性多

9、飲(消渴消渴)等。等。 Psychosomatic diseases in the endocrine system include diabetes (diabetes), hyperthyroidism (goiter), obesity (phlegm syndrome), diabetes insipidus (diabetes), and psychogenic excessive drink of water (diabetes). 12 6、泌尿生殖系統心身疾?。骸⒚谀蛏诚到y心身疾?。?前列腺炎前列腺炎(白濁白濁)，過敏性膀胱炎，過敏性膀胱炎(淋癥淋癥)、 尿道綜合癥尿道綜合癥

10、(淋癥淋癥)、原發(fā)性性功能障礙、原發(fā)性性功能障礙(陽陽 痿、早泄痿、早泄)等等 Psychosomatic diseases in the urogenital system include prostatitis (gonorrhea), allergic cystitis (stranguria), urethral syndrome (stranguria) and primary sexual disorder (impotence and premature ejaculation). 13 7、骨骼肌肉系統心身疾?。?、骨骼肌肉系統心身疾?。?類風濕類風濕(痹證痹證)、全身肌肉痛、全

11、身肌肉痛(痹證痹證)、 書寫痙攣書寫痙攣(振顫振顫)、局部性肌痙攣、局部性肌痙攣(振顫振顫)等。等。 Psychosomatic diseases in the skeletal and muscular systems include rheumatoid disease (arthralgia syndrome), pain in muscles throughout the body (arthralgia syndrome), writing spasm (tremor) and local muscular spasm (tremor). 14 8、外科系統心身疾病：、外科系統心身疾

12、?。?包括腹部手術不適綜合證包括腹部手術不適綜合證(腹痛腹痛)、 腸粘連癥腸粘連癥(便秘便秘)，等。，等。 Psychosomatic diseases in the surgical department include uncomfortable syndrome of abdominal operation (abdominal pain) and intestinal adhesion (constipation). 15 9、婦產科心身疾?。骸D產科心身疾病： 包括痛經包括痛經(痛經痛經)、閉經、閉經(經閉經閉)、月經不調、月經不調(月經月經 先期、后期、先后不定先期、后期、先后不定

13、)、功能性子宮出血、功能性子宮出血(崩崩 漏漏)、更年期經前后諸癥、更年期經前后諸癥)、不孕癥、不孕癥(不孕不孕) Psychosomatic in the department ofgynecology andobstetricsincludedysmenorrhea(dysmenorr hea), amenia(amenia), irregular menstruation (advanced ordelayedenstruation),dysfunctional uterine bleeding (metrorrhagiaandmetrostaxis), menopausalsyndro

14、me(diseasesaroundmenopau se) and infertility (infertility). 16 10、兒科心身疾?。骸嚎菩纳砑膊。?神經性厭食癥神經性厭食癥(厭食厭食)、遺尿癥、遺尿癥(遺尿遺尿)、 腹痛腹痛(腹痛腹痛)、頭痛、頭痛(頭痛頭痛)等。等。 Psychosomatic diseases in the department of pediatrics include nervous anorexia (anorexia), enuresis (enuresis), abdominal pain (abdominal pain) and headache

15、 (headache). 17 11、皮膚科心身疾病：、皮膚科心身疾?。?濕疹濕疹(濕毒瘡濕毒瘡)、牛皮癬、牛皮癬(白瘡白瘡)、痤瘡、痤瘡(粉刺粉刺)、 斑禿斑禿(油風油風)、慢性麻疹、慢性麻疹(風疹塊風疹塊)、多汗癥、多汗癥(汗汗 證證)、皮膚瘙癢癥、皮膚瘙癢癥(風搔癢風搔癢)等。等。 Psychosomatic diseases in the department of dermatology include eczema (noxious dampness), psoriasis, acne (acne), alopecia areata (alopecia areata), chron

16、ic urticaria (rubella), hyperhidrosis (sweating syndrome) and cutaneous pruritus (pruritus cutis). 18 12、眼科心身疾?。?、眼科心身疾?。?原發(fā)性青光眼原發(fā)性青光眼(五風內障五風內障)、中心性視網膜炎、中心性視網膜炎 (視惑視惑)、飛蚊癥、飛蚊癥(云霧移晴云霧移晴)、白內障、白內障(園翳內園翳內 障障)、眼睛癔癥、眼睛癔癥(暴盲暴盲)等等 Psychosomatic diseases in the department of ophthalmology include primary glau

17、coma (glaucoma), central choroido-retiritis (blurring vision), flying mosquito disease (vitreous opacity), cataract (cataract) and ocular hysteria (sudden loss of vision). 19 13、耳鼻喉科心身疾病：、耳鼻喉科心身疾病： 心因性耳聾心因性耳聾(耳聾耳聾)、美尼爾氏征、美尼爾氏征(眩暈眩暈)、 失音失音(喉喑喉喑)、過敏性鼻炎、過敏性鼻炎(鼻鼽鼻鼽)等。等。 Psychosomatic diseases in the dep

18、artment of otolaryngology include psychogenic deafness (deafness), Menieres disease (dizziness), aphonia (aphonia due to throat disease) and allergic rhinitis (allergic rhinitis). 20 14、口腔科心身疾病：、口腔科心身疾?。?口臭口臭(口臭口臭)、口腔潰瘍、口腔潰瘍(口瘡口瘡)、 特發(fā)性舌痛特發(fā)性舌痛 (舌痛舌痛)、心因性牙痛、心因性牙痛(牙痛牙痛)等。等。 Psychosomatic diseases in th

19、e department of stomatology include ozostomia (ozostomia), stomatocace (aphthae), idiopathic glossalgia (glossalgia), psychogenic toothache (toothache). 21 15、腫瘤科心身疾病：、腫瘤科心身疾?。?胃癌胃癌(積聚積聚)、肝癌、肝癌(脅痛脅痛) 腸癌腸癌(便血便血)、 食道癌食道癌(噎嗝噎嗝)等。等。 Psychosomatic diseases in the department of tumor include carcinoma of

20、stomach (abdominal mass), liver cancer (hypochondriac pain), intestinal cancer (hemafecia) and carcinoma of esophagus (dysphagia). 22 16. 心身性亞健康 Sub-Health 23 應對心身疾病的挑戰(zhàn)是世界醫(yī)學應對心身疾病的挑戰(zhàn)是世界醫(yī)學 的共同責任，的共同責任，1977年美國提出醫(yī)學模年美國提出醫(yī)學模 式轉變，但至今沒有形成完整的理論式轉變，但至今沒有形成完整的理論 和方法，沒有實現心身整合的目標。和方法，沒有實現心身整合的目標。 It is our res

21、posibility 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. 24 19901990年去日本九州大學醫(yī)學部向國際心年去日本九州大學醫(yī)學部向國際心 身醫(yī)學會理事長池見酉次郎教授學習身醫(yī)學會理事長池見酉次郎教授學習。 25 19961996年去日本九州大學醫(yī)學部心療內科，年去日本九州大學醫(yī)學部心療內科， 進修心身醫(yī)

22、學。現任亞洲心身醫(yī)學會會長進修心身醫(yī)學?，F任亞洲心身醫(yī)學會會長 久保千春教授久保千春教授。 26 27 存在決定意識，需求決定發(fā)展，防存在決定意識，需求決定發(fā)展，防 治心身疾病成為醫(yī)學發(fā)展的方向，壓力治心身疾病成為醫(yī)學發(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 任何時期。任何時期。 Demand determines development. Demand determines development. The prevention and cure of The prevention and cure of psychosomatic diseas

23、es is the new psychosomatic diseases is the new direction of medicine. direction of medicine. 中醫(yī)學的創(chuàng)新與發(fā)展中醫(yī)學的創(chuàng)新與發(fā)展 28 二、中醫(yī)心身醫(yī)學理論與臨床二、中醫(yī)心身醫(yī)學理論與臨床 2.The theory and clinical research of TCM Psychosomatic Medicine 29 30 第一個時代第一個時代春秋戰(zhàn)國時期春秋戰(zhàn)國時期 The first stage-Spring and Autumn The first stage-Spring and Au

24、tumn and Warring States periods of China and Warring States periods of China (770 BC -221 BC)(770 BC -221 BC) 精氣學說、陰陽學說、五行學精氣學說、陰陽學說、五行學 說、臟象學說、以及病因病機，說、臟象學說、以及病因病機， 診斷治療，預防養(yǎng)生等各個方診斷治療，預防養(yǎng)生等各個方 面。面。 黃帝內經 黃帝內經 31 第二個時代第二個時代 東漢時期東漢時期 The second stage-Eastern The second stage-Eastern Han Dynasty (25AD-2

25、20AD)Han Dynasty (25AD-220AD) 三陰三陽的傷寒病六經辯證三陰三陽的傷寒病六經辯證 經方派經方派 傷寒論 傷寒論 32 第三個時代第三個時代金元時期金元時期 The third stage-Jin and Yuan The third stage-Jin and Yuan Dynasty (1115AD-1368AD)Dynasty (1115AD-1368AD) 劉完素劉完素 張子和張子和 李東垣李東垣 朱丹溪朱丹溪 寒涼寒涼 攻下攻下 補土補土 滋陰滋陰 金元四大家金元四大家 33 第四個時代第四個時代清代清代 The fourth stage-Qing Dyna

26、sty The fourth stage-Qing Dynasty (1644-1911AD)(1644-1911AD) 葉天士葉天士 吳鞠通吳鞠通 等等 溫病衛(wèi)氣營血辯證和三焦辯證溫病衛(wèi)氣營血辯證和三焦辯證 溫熱論 溫熱論 34 The fifth stage- Psychosomatic Medicine 心身醫(yī)學的時代心身醫(yī)學的時代 第五個時代第五個時代 35 (2) Research on Etiology and Pathogenesis of TCM psychosomatic medicine 36 “形神合一論形神合一論”“”“天人合一天人合一 論論”“”“臟腑相關論臟腑相關論

27、”“”“陰陽陰陽 五行學說五行學說”。“The theory on combination of physique and mentality i n t o o n e ” , “ t h e t h e o r y o n correspondence between man and universe”, “the theory on relations between zang and fu” and “the theory on yin-yang and five elements” 37 “主明則下安主明則下安，主不明則十二官危，主不明則十二官危， 使道閉塞不通，形乃大傷使道閉塞不通

28、，形乃大傷”“”“悲哀愁憂悲哀愁憂 則心動，心動則五臟六腑皆搖則心動，心動則五臟六腑皆搖”“”“精神精神 內傷，身內傷，身必敗亡必敗亡” 精辟地闡述了心理精辟地闡述了心理 對生理的影響對生理的影響 .“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, affectin

29、g all internal organs.” 38 “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)的心理生理具有陰陽。中醫(yī)的心理生理具有陰陽 剛柔對立統一的特點剛柔對立統一的特點, ,歸納為歸納為“中醫(yī)剛中醫(yī)剛 柔心身論柔心身論”( (剛柔心理生理學說剛柔心理生理學說) )。 “People by birth have yin and yang, short and long, flexibilityandrigidity.”Therefore,TCM psychophysiology is characterized by the unity

30、of opposites between yin and yang and between flexibility and rigidity. The authors sum it up as “the flexible-rigid theory on TCM psychosomatic medicine” (the flexible-rigid doctrine on psychophysiology). 39 關于病因關于病因內經內經的正的正( (內因內因) )，邪，邪( (外外 因因) )學說與現代心身醫(yī)學認識一致。內學說與現代心身醫(yī)學認識一致。內 因有先天稟賦、氣質、體質。外因有因有先

31、天稟賦、氣質、體質。外因有 七情、六淫和飲食勞逸等。是心理、七情、六淫和飲食勞逸等。是心理、 社會、生物、生活方式、行為等各種社會、生物、生活方式、行為等各種 應激因素。應激因素。 Neijing is identical to modern psychosomatic medicine in the theory on internalandexternalfactors.Internalfactorsinclud econgenitalendowment,temperament and physique. External factors include seven emotions, s

32、ix climatic conditions ,diet, labor and rest. 40 調查內因可以找出心理素質和生理調查內因可以找出心理素質和生理 素質的虛弱所在，即正氣虛的表現。調素質的虛弱所在，即正氣虛的表現。調 查外因則可找出心理、社會、生物、行查外因則可找出心理、社會、生物、行 為諸種致病因素，即邪氣實的表現。為諸種致病因素，即邪氣實的表現。 Investigation into internal factors can find what are feeble in psychological and physiological quality, which is man

33、ifested in deficiency of vital qi.Investigation into external factors can find disease-causing factors of psychology, sociality, biology and behavior, which is manifested in excess of pathogen. 41 If the patient was noble in the past and is now humble, although he had not attacked by the evil, he ha

34、s disease produced from the interior. If he was rich in the past and is now poor that causes the diseases. 凡診病者，必問嘗貴后賤，雖不凡診病者，必問嘗貴后賤，雖不 中邪，病從內生，名曰脫營中邪，病從內生，名曰脫營 INTERNAL CLASSIC 42 Anger injuries liver, joy injuries heart, grief injuries lung, thinking injuries spleen and fear injuries kidney Intern

35、al classic 怒傷肝怒傷肝 、喜傷心、思傷脾、憂傷肺、喜傷心、思傷脾、憂傷肺、 恐傷腎恐傷腎 43 44 45 In the treatment of psychosomatic diseases, TCM always stresses “psychological treatment before physiological treatment”. The authors have for more than a decade summarized TCM methods for the treatment of psychosomatic diseases as of 9 typ

36、es.(九寶合璧九寶合璧) 46 4 4、心身疾病的剛柔辯證、心身疾病的剛柔辯證 （4） Rigid-Gental Differentiation of Psychosomatic diseases 根據國內外的資料和自己的臨床實 踐總結如下： 47 發(fā)病后首先傷肝，波及心、脾、肺， 日久及腎。初期多為肝脾同病，肝心同 病，肝肺同病，后期多為肝腎陰虛或肝 脾腎的陽虛。末期陰竭、陽亡、陰陽離 絕而終。 In early stage, the diseases are mainly at both liver and spleen, both liver and heart, or both li

37、ver and lung. In late stage, the diseases are mainly manifested in yin-deficiency of the liver 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. 48 病性為剛柔不能相濟，而致病性為剛柔不能相濟，而致 疏泄失職，氣滯血瘀，痰阻濕疏泄

38、失職，氣滯血瘀，痰阻濕 困或氣逆化火，火熱傷陰，升困或氣逆化火，火熱傷陰，升 降失司，日久由實轉虛，脾虛降失司，日久由實轉虛，脾虛 肝郁或腎虛肝旺，極少純虛證。肝郁或腎虛肝旺，極少純虛證。 （看下張英文）（看下張英文） 49 The 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 da

39、mpness, fire due to adverse flow of qi, impairment of yin due to fire, and disorder in ascension and 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. Ver

40、y few patients suffer from deficiency syndrome. 50 心身疾病經過及時合理的治療，多有心身疾病經過及時合理的治療，多有 較好的療效，但容易因情志因素復發(fā)。較好的療效，但容易因情志因素復發(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 t

41、o emotional factors. 51 少數患者因治療不當，可由實轉虛，最少數患者因治療不當，可由實轉虛，最 后陰亡或陽亡而終。另有少數患者可因后陰亡或陽亡而終。另有少數患者可因 劇烈的情志刺激、氣血暴逆或氣血暴脫，劇烈的情志刺激、氣血暴逆或氣血暴脫， 精去神亡。精去神亡。 Patients with improper treatment can transform from excess to deficiency and will finally die of yin-vanish or yang-vanish. Other patients could die of sudden

42、ly adverse flow of qi and blood or sudden collapse of qi and blood due to violent emotional stimulation. 52 心身疾病剛柔辨證論治心身疾病剛柔辨證論治 心理社會壓力心理社會壓力 情志過激情志過激傷肝傷肝 剛剛 證證柔柔 證證 病機病機 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 實實 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 心肝火旺痰瘀互結心肝火旺痰瘀互結瀉肝清心化痰活血瀉肝清心化痰活血 虛虛 證證 心肝

43、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 肝腎陰虛風動肝腎陰虛風動滋補肝腎熄風滋補肝腎熄風 陰損及陽陰損及陽滋陰助陽滋陰助陽 結局結局 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肝養(yǎng)心補肝養(yǎng)心 脾腎陽虛脾腎陽虛溫補脾腎溫補脾腎 陽損及陰陽損及陰補陽助陰補陽助陰 陽亡陰亡陽亡陰亡 53 心身疾病剛證柔證辯證論治心身疾病剛

44、證柔證辯證論治 心理社會壓力、情志刺激心理社會壓力、情志刺激 實證 素體性急陽剛疏泄太過肝旺一剛證剛證 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 心肝火旺痰瘀互結一瀉肝清心化痰活血 素體性緩陰柔疏泄不及一肝郁一柔證柔證 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 肝腎陰虛風動滋補肝腎熄風 陰損及陽滋陰助陽 肝郁脾虛一疏肝健脾 心肝氣虛一補肝養(yǎng)心 脾腎陽虛溫補脾腎 陽損及陰一補陽助陰 結結 局局 陰亡陽亡陽亡陰亡 54 There are 2 classes, 4 items, 16

45、 families in differentiation of syndromes according to the Rigid-Gental theory. 55 2 classes are: 56 肝氣上逆肝氣上逆 肝火上炎肝火上炎 心肝火旺心肝火旺 心肝火旺痰瘀互結心肝火旺痰瘀互結 57 肝郁氣滯肝郁氣滯 肝郁血瘀肝郁血瘀 肝郁脾困肝郁脾困 肝郁痰濕阻肺肝郁痰濕阻肺 58 心肝陰虛心肝陰虛 肝腎陰虛肝陽上亢肝腎陰虛肝陽上亢 肝腎陰虛風動肝腎陰虛風動 陰損及陽陰損及陽 59 Stasis of liver and insufficient of spleen 肝郁脾虛肝郁脾虛 Insuff

46、icient Qi of heart and liver 心肝氣虛心肝氣虛 Insufficient Yang of spleen and kidney 脾腎陽虛脾腎陽虛 Insufficient Yang result in insufficient Yin 陽損及陰陽損及陰 60 irritated 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 whi

47、te苔白苔白 Halitosis口臭口臭 fishy smell口腥口腥 61 Edgy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Quiet安靜安靜 Easily express emotion 善于表達感情 Hardly express emotion不易表達感情 62 心身疾病的中醫(yī)診斷，繼承傳統的四心身疾病的中醫(yī)診斷，繼承傳統的四 診，辨病和辨證，再吸收現代心身醫(yī)學診，辨病和辨證，再吸收現代心身醫(yī)學

48、的心理診斷和軀體診斷兩部分內容。軀的心理診斷和軀體診斷兩部分內容。軀 體診斷與一般西醫(yī)診斷相同。為中醫(yī)心體診斷與一般西醫(yī)診斷相同。為中醫(yī)心 身疾病的療建立客觀依據。身疾病的療建立客觀依據。 On diagnosis of psychosomatic diseases in TCM, four traditional diagnoses, differentiation of diseases and syndromes should be inherited, and psychological and physiological diagnoses in modern psychosomat

49、ic medicine should be absorbed. TCM is identical to Western medicine in physiological diagnosis. 63 5 5、病、病 例例 Case Report 64 Case Report Mr. Han, 49y 男，男，49歲歲 Complaint: chest pain and tightness for 3 days 主訴：胸憋胸痛主訴：胸憋胸痛3天天 65 History: he complained chest pain and tightness for 3 days and felt grad

50、ually 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 evidence of infarct. 工作緊張的人、癥狀不斷加劇、急診住院、冠狀造影排工作緊張的人、癥狀不斷加劇、急診住院、冠狀造影排 除心梗除心梗 病病 例例 66 Treatment to symptoms was not effec

51、tive. The doctor there referred him to our traditional Chinese medicine hospital. 西醫(yī)對癥治療無效推薦來我科看病西醫(yī)對癥治療無效推薦來我科看病 67 Except for the above symptoms, the patient also complained: Shortness of breath, abdominal distention, chest palpitation, poor appetite, and depression. EEG & brain atlas (BA) is abnor

52、mal. 氣短、心慌、食欲減少、情緒低落氣短、心慌、食欲減少、情緒低落 心電圖、腦電地形圖異常心電圖、腦電地形圖異常 68 西醫(yī)診斷為心臟神經癥西醫(yī)診斷為心臟神經癥 Preliminary diagnosis of west Medicine: neurocardiac syndrome. 69 His Symptoms by TCM 癥狀癥狀 Tired spirit Sallow complexion Quiet Patient Tongue coating is white Diagnosis of TCM(Step 1) 診斷診斷 70 His Symptoms by TCM 癥狀癥狀

53、 Diagnosis of TCM(Step 2)診斷診斷 Red tongue Chest pain and tightness Abdominal distention 71 His Symptoms by TCM Diagnosis of TCM(Step 3) Tongue with purple spots The pain point is fixed 證候證候癥狀癥狀 72 Diagnosis of TCM(Step 3)診斷診斷 Treatment of TCM 治療治療 Xufu Zhuyu Decoction 73 Result One month later All sy

54、mptoms disappeared. ECG: normal EEG & BA: normal 治療一個月之后，治療一個月之后， 癥狀消失，心、腦電圖正常癥狀消失，心、腦電圖正常 74 治療治療 前前 Before 治療后治療后 After 75 Hundreds of Successful Cases Cholecystitis 膽囊炎膽囊炎 Angina pectoris 冠心病冠心病 Neurogenic headache神經性頭痛神經性頭痛 Cardiac arrhythmia 心律失常心律失常 這樣的病例有數百例這樣的病例有數百例 76 The Number of Outpatients門診量門診量 800-900 personstimes/month每月每月 10,000 personstimes/year每年每年 77 近年近年 處方處方 病例病例 78 中醫(yī)心身醫(yī)學優(yōu)于西醫(yī)中醫(yī)心身醫(yī)學優(yōu)于西醫(yī) TCM compares with Western Medicine 1 1、方法多、方法多 More methodsMore methods 2 2、效果好、效果好 Better effectBetter effect 4 4、節(jié)省醫(yī)藥費、節(jié)省醫(yī)藥費 Less expenseLess expense 79 研制了