抑郁症证候学规律及解郁清心安神汤临床疗效的研究
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摘要
本课题分为证候学研究和临床疗效研究两部分。
1.证候学研究：
目的：本研究针对164例患者进行证候观察,探讨抑郁症的发病特点、中医病机及最常见症状。方法：(1)总结抑郁症患者性别、年龄、性格等一般情况构成比。(2)应用抑郁自评量表(SDS)分析抑郁症轻、中、重分布情况。应用Hamilton抑郁量表(HAMD)、匹兹堡睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)分析伴发睡眠障碍、焦虑情况。(3)制定中医症状观察表,每个症状都进行量化评分,一般症状按照O、1、2、3、4分评定,舌脉不参与评分,总结出抑郁症最主要的症状及病机。结果：(1)所调查的164例抑郁症患者,年龄在18-74岁之间,平均年龄为35.22±12.30岁。一般资料中,女性占57.3%；文化程度为中学及大学者占75.0%；体力劳动者占47.6%；已婚者占83.6%；性格急躁者占30.6%；收入<3000元/月者占72.5%。(2)入睡困难、睡眠不深、早醒三者兼有者占57.9%；精神性焦虑占72.1%,轻中度抑郁者占90.9%。(3)抑郁症证型有六个,分别为肝火扰心型、肝气郁滞型、痰气郁结型、心脾两虚型、肝肾阴虚型、阴虚火旺型,其中肝火扰心型占32.9%。主要症状共21个,以精神性症状为主。结论：在164例抑郁症患者中,中青年人占多数,其中女性、文化程度中学及大学者、体力劳动者、已婚者、性格急躁者、收入<3000元/月者居多。睡眠障碍以入睡困难、睡眠不深、早醒三者兼有居多；焦虑症状以精神性焦虑居多。轻中度抑郁症患者占多数。中医症状以精神症状居多,证型以肝火扰心证最为常见。
2.临床疗效研究：
目的：观察肝郁化火、扰心伤神型抑郁症患者应用解郁清心安神汤干预的疗效。方法：对符合纳入标准的54例患者分为治疗组和对照组,每组27人,治疗组给予解郁清心安神汤,对照组给予逍遥散治疗,两组均治疗12周,半年后随访,应用《抑郁症中医证候临床观察表》、SDS、SAS、PSQI评分评定。结果：临床总有效率及量表积分比较结果(1)患者中医证候总有效率及量表积分各治疗时点比较：①中医证候总有效率比较,p<0.05,差异有统计学意义。②中医证候量表积分各时间点比较：组内比较：治疗组及对照组中医证候在治疗4周、8周、12周、半年随访与治疗前比较,p<0.05,差异有统计学意义。组间比较：情绪抑郁、悲观厌世治疗4周两组比较,p>0.05,差异无统计学意义,治疗8周、12周、半年随访比较,p<0.05,差异有统计学意义；兴趣索然、神思不聚治疗4周、8周、12周、半年随访比较,p<0.05,差异有统计学意义；少寐、急躁易怒治疗4周、8周、12周、半年随访比较,p>0.05,差异无统计学意义；胸胁胀满半年随访比较,p<0.05,差异有统计学意义。(2)患者SDS量表总有效率及量表积分各时间点比较①SDS量表总有效率比较,p<0.05,差异有统计学意义。②SDS量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化；组间比较,p<0.01,说明治疗组与对照组随时间变化有差异。(3)患者SAS量表总有效率及量表积分各时间点比较①SAS量表总有效率比较,p<0.05,差异有统计学意义。②SAS量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化；组间比较,p<0.05,说明治疗组与对照组随时间变化有差异。(4)患者PSQI量表总有效率及各量表积分各时间点比较①PSQI量表总有效率比较,p<0.05,差异有统计学意义。②PSQI量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化。组间比较,p<0.01,说明治疗组与对照组随时间变化有差异。结论：临床研究结果证实了解郁清心安神汤治疗抑郁症疗效肯定,是治疗抑郁症安全可靠的有效方药。
This research project is divided into syndrome and clinical parts:
1.The research on syndrome:
Objective:In this study,164 cases are observed in patients with syndrome, to investigate the clinical characteristics of depression, tcm pathogenesis and the most common symptoms.Methods:(1) Summarizing the constituent ratio of depression gender, age, character etc. (2) Application of depression checklist (SDS) analyzing depression mild, heavy distribution. Application of Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index Scale (PSQI), anxiety checklist (SAS) analyzing accompanied sleep obstacles Anxiety. (3) Development of clinical symptoms observed table, each symptom score to quantify all the general symptoms assessed with 0,1,2,3,4 points,but tongue and pulse picture do not participate, in order to sum up the major depression symptoms and pathogenesis.Results:(1)164 cases are from 18 to 74 years old, mean age is 35.22±12.30. In the general information, women for 57.3%.Education for secondary schools and universities for 75%. Manual workers for 47.6%. 83.6% married. Impetuous for 30.6%. Income less than 3,000 yuan per month for 72.5%.(2) Difficulty falling asleep, sleep lightly and waking early for 57.9% of all. Mental anxiety for 72.1%.Mild and moderate depression for 90.9%.(3) Six types of syndrome:Gan huo rao xin,gan qi yu zhi,tan qi yu jie, xin pi liang xu, gan shen yin xu, yin xu huo wang, and gan huo rao xin type of which accounted for 32.9%. A total of 21 main symptoms,and the main are the spirit ones.Conclusion:In the 164 cases of the observation, to the majority of young people, including women, education secondary schools and universities, laborers, married, impetuous character, income less than 3,000 yuan per month.Sleep difficulties, sleep lightly, early awakening all the three majority.Mostly mental anxiety. Mild and moderate depression in the majority. TCM to the majority of psychiatric symptoms, gan huo rao xin type being the most common disturbance of evidence.
2.The research of clinical effect:
Objective:To explore the effect of Jieyu Qingxin Anshen tang and Xiaoyaosan intervening the depression of gan huo rao xin type.Methods:54 cases of the depressive patients who meet the inclusion criteria are for the comparative study on Jieyu Qinxin Anshen tang and Xiaoyaosan. Both groups are treated for 12 weeks and are follow-up after six months. Assessing score with "syndromes of depression clinical observation table", SDS, SAS, PSQI.Results:The comparison of the total effective rate and scale score results (1)The syndromes and the scale score total efficiency at each time point treatment:①The syndrome total effective rate, P<0.05.②The syndrome scale score at each time point comparison:Group comparison:The treatment and control groups at the treatment of 4weeks、8weeks、12weeks、six months follow-up, P<0.05. Between groups:Depression, pessimism, in comparing the two groups treated for 4 weeks, p>0.05. Treated for 8 weeks, 12 weeks, six months follow-up, p<0.05. Interested in dry, meditation not gathering treated for 4 weeks,8 weeks,12 weeks, six months follow-up, p<0.05. Less sleep soundly, irritability treated for 4 weeks,8 weeks,12 weeks, six months follow-up, p>0.05.Xiongxie fullness six months follow-up, p<0.05. (2) The SDS scale efficiency and the total scale score at each time point comparison①The SDS scale the total effective rate, P<0.05.②The SDS scale score comparison:Group comparison, P<0.01, between the two groups, P<0.01.(3)The comparison of SAS scale efficiency and the total scale score at each time point①The SAS scale the total effective rate, P<0.05.②The SAS scale score comparison: Group comparison, P<0.01, between groups, P<0.05.(4) The comparison of PSQI scale efficiency and the total scale score at each time point①The PSQI total effective scale, P<0.05, significantly.②The PSQI scale score comparison:Group comparison, P<0.01.Between groups, P<0.01.
Conclusions:The findings about Jie Yu Qingxin Anshen Tang is effective and the treatment of depression is safe.
1.证候学研究：
目的：本研究针对164例患者进行证候观察,探讨抑郁症的发病特点、中医病机及最常见症状。方法：(1)总结抑郁症患者性别、年龄、性格等一般情况构成比。(2)应用抑郁自评量表(SDS)分析抑郁症轻、中、重分布情况。应用Hamilton抑郁量表(HAMD)、匹兹堡睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)分析伴发睡眠障碍、焦虑情况。(3)制定中医症状观察表,每个症状都进行量化评分,一般症状按照O、1、2、3、4分评定,舌脉不参与评分,总结出抑郁症最主要的症状及病机。结果：(1)所调查的164例抑郁症患者,年龄在18-74岁之间,平均年龄为35.22±12.30岁。一般资料中,女性占57.3%；文化程度为中学及大学者占75.0%；体力劳动者占47.6%；已婚者占83.6%；性格急躁者占30.6%；收入<3000元/月者占72.5%。(2)入睡困难、睡眠不深、早醒三者兼有者占57.9%；精神性焦虑占72.1%,轻中度抑郁者占90.9%。(3)抑郁症证型有六个,分别为肝火扰心型、肝气郁滞型、痰气郁结型、心脾两虚型、肝肾阴虚型、阴虚火旺型,其中肝火扰心型占32.9%。主要症状共21个,以精神性症状为主。结论：在164例抑郁症患者中,中青年人占多数,其中女性、文化程度中学及大学者、体力劳动者、已婚者、性格急躁者、收入<3000元/月者居多。睡眠障碍以入睡困难、睡眠不深、早醒三者兼有居多；焦虑症状以精神性焦虑居多。轻中度抑郁症患者占多数。中医症状以精神症状居多,证型以肝火扰心证最为常见。
2.临床疗效研究：
目的：观察肝郁化火、扰心伤神型抑郁症患者应用解郁清心安神汤干预的疗效。方法：对符合纳入标准的54例患者分为治疗组和对照组,每组27人,治疗组给予解郁清心安神汤,对照组给予逍遥散治疗,两组均治疗12周,半年后随访,应用《抑郁症中医证候临床观察表》、SDS、SAS、PSQI评分评定。结果：临床总有效率及量表积分比较结果(1)患者中医证候总有效率及量表积分各治疗时点比较：①中医证候总有效率比较,p<0.05,差异有统计学意义。②中医证候量表积分各时间点比较：组内比较：治疗组及对照组中医证候在治疗4周、8周、12周、半年随访与治疗前比较,p<0.05,差异有统计学意义。组间比较：情绪抑郁、悲观厌世治疗4周两组比较,p>0.05,差异无统计学意义,治疗8周、12周、半年随访比较,p<0.05,差异有统计学意义；兴趣索然、神思不聚治疗4周、8周、12周、半年随访比较,p<0.05,差异有统计学意义；少寐、急躁易怒治疗4周、8周、12周、半年随访比较,p>0.05,差异无统计学意义；胸胁胀满半年随访比较,p<0.05,差异有统计学意义。(2)患者SDS量表总有效率及量表积分各时间点比较①SDS量表总有效率比较,p<0.05,差异有统计学意义。②SDS量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化；组间比较,p<0.01,说明治疗组与对照组随时间变化有差异。(3)患者SAS量表总有效率及量表积分各时间点比较①SAS量表总有效率比较,p<0.05,差异有统计学意义。②SAS量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化；组间比较,p<0.05,说明治疗组与对照组随时间变化有差异。(4)患者PSQI量表总有效率及各量表积分各时间点比较①PSQI量表总有效率比较,p<0.05,差异有统计学意义。②PSQI量表积分比较：组内比较,p<0.01,说明治疗组及对照组均随时间变化。组间比较,p<0.01,说明治疗组与对照组随时间变化有差异。结论：临床研究结果证实了解郁清心安神汤治疗抑郁症疗效肯定,是治疗抑郁症安全可靠的有效方药。
This research project is divided into syndrome and clinical parts:
1.The research on syndrome:
Objective:In this study,164 cases are observed in patients with syndrome, to investigate the clinical characteristics of depression, tcm pathogenesis and the most common symptoms.Methods:(1) Summarizing the constituent ratio of depression gender, age, character etc. (2) Application of depression checklist (SDS) analyzing depression mild, heavy distribution. Application of Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index Scale (PSQI), anxiety checklist (SAS) analyzing accompanied sleep obstacles Anxiety. (3) Development of clinical symptoms observed table, each symptom score to quantify all the general symptoms assessed with 0,1,2,3,4 points,but tongue and pulse picture do not participate, in order to sum up the major depression symptoms and pathogenesis.Results:(1)164 cases are from 18 to 74 years old, mean age is 35.22±12.30. In the general information, women for 57.3%.Education for secondary schools and universities for 75%. Manual workers for 47.6%. 83.6% married. Impetuous for 30.6%. Income less than 3,000 yuan per month for 72.5%.(2) Difficulty falling asleep, sleep lightly and waking early for 57.9% of all. Mental anxiety for 72.1%.Mild and moderate depression for 90.9%.(3) Six types of syndrome:Gan huo rao xin,gan qi yu zhi,tan qi yu jie, xin pi liang xu, gan shen yin xu, yin xu huo wang, and gan huo rao xin type of which accounted for 32.9%. A total of 21 main symptoms,and the main are the spirit ones.Conclusion:In the 164 cases of the observation, to the majority of young people, including women, education secondary schools and universities, laborers, married, impetuous character, income less than 3,000 yuan per month.Sleep difficulties, sleep lightly, early awakening all the three majority.Mostly mental anxiety. Mild and moderate depression in the majority. TCM to the majority of psychiatric symptoms, gan huo rao xin type being the most common disturbance of evidence.
2.The research of clinical effect:
Objective:To explore the effect of Jieyu Qingxin Anshen tang and Xiaoyaosan intervening the depression of gan huo rao xin type.Methods:54 cases of the depressive patients who meet the inclusion criteria are for the comparative study on Jieyu Qinxin Anshen tang and Xiaoyaosan. Both groups are treated for 12 weeks and are follow-up after six months. Assessing score with "syndromes of depression clinical observation table", SDS, SAS, PSQI.Results:The comparison of the total effective rate and scale score results (1)The syndromes and the scale score total efficiency at each time point treatment:①The syndrome total effective rate, P<0.05.②The syndrome scale score at each time point comparison:Group comparison:The treatment and control groups at the treatment of 4weeks、8weeks、12weeks、six months follow-up, P<0.05. Between groups:Depression, pessimism, in comparing the two groups treated for 4 weeks, p>0.05. Treated for 8 weeks, 12 weeks, six months follow-up, p<0.05. Interested in dry, meditation not gathering treated for 4 weeks,8 weeks,12 weeks, six months follow-up, p<0.05. Less sleep soundly, irritability treated for 4 weeks,8 weeks,12 weeks, six months follow-up, p>0.05.Xiongxie fullness six months follow-up, p<0.05. (2) The SDS scale efficiency and the total scale score at each time point comparison①The SDS scale the total effective rate, P<0.05.②The SDS scale score comparison:Group comparison, P<0.01, between the two groups, P<0.01.(3)The comparison of SAS scale efficiency and the total scale score at each time point①The SAS scale the total effective rate, P<0.05.②The SAS scale score comparison: Group comparison, P<0.01, between groups, P<0.05.(4) The comparison of PSQI scale efficiency and the total scale score at each time point①The PSQI total effective scale, P<0.05, significantly.②The PSQI scale score comparison:Group comparison, P<0.01.Between groups, P<0.01.
Conclusions:The findings about Jie Yu Qingxin Anshen Tang is effective and the treatment of depression is safe.
引文
[1]美国精神病学会.精神障碍诊断统计手册第四版(DSM-Ⅳ).上海精神医学,1994；增6：85.
[2]中华医学会精神学会.中国精神障碍分类与诊断标准第三版(CCMD-III).济南：山东科学技术出版社,2001,第一版：87-89.
[3]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：214.
[4]American Psychiatric association, Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ), Washington DC,1994.
[5]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：223.
[6]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：292.
[7]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：213.
[8]国家中医药管理局.中华人民共和国中医药行业标准·中医病证诊断疗效标准.北京：南京大学出版社,1994：20—21.
[9]国家技术监督局.中华人民共和国国家标准中医临床诊疗术语·证候部分.北京：中国标准出版社,1997：18,23,30-31,37-38.
[10]Mohammadi MR, Davidian H, Noorbala AA etal. An epidemiological survey of psychiatric disorders in Iran. Clin Pract Epidemoilment Health,2005, 26; 1:16.
[11]王红霞,张会嚣,吕红梅.围绝经期妇女抑郁症状及其影响因素探讨[J].护理学杂志,2005,20(18)：66-67.
[12]于皎.辨证治疗抑郁症46例疗效观察及护理体会[J].河南中医,2006,26(3)：36-37.
[13]郑开梅,武成,薛蕾等.抑郁症中医证候学临床流行病学调查[J].天津中医药大学学报,2006,25(3)：170-171.
[14]Nolen—Hoeksema. Genderdifference in coping with depression across the lifespan[J]. Depression,1995, (3):81-90.
[15]袁静,李坚.女性抑郁症相关因素的研究进展[J].中国妇幼保健,2007,25 (22)3609-3611.
[16]马欢.抑郁症病因病机研究探析[J].辽宁中医杂志,2005,32(6)：537-538.
[17]PattenSB. Incidence of major depression in Canada.Canadian Medical Association 2000:163:74-5.
[18]Sandra Harris.Abnormal Psychology:The problem of Maladaptive Be-havioral (Media and Research Update) 10th ed. New Jersey:Pearson Edu-cation 2004:10-11.
[19]王瑞红.大学生双性化人格特质与情绪状态的相关研究[J].山东省青年管理干部学院学报,2005,22(1)：49—50.
[20]Poli P, Sbrana B, Marcheschi M, etal. Self-reported depressive Symptoms in a school sample of Italian children and adolescents. Child Psychiatry Hum Dev 2003W33 (3):20-26.
[21]陈文垲,周玲,梅晓云等.571例抑郁症中医证候学临床流行病学调查[J].浙江中医杂志,2007,42(5)：262-264.
[22]王世宏.谢兆丰老中医治疗五脏郁证的经验[J].江苏中医,1996,17(1)：7-8.
[23]畅洪升,王庆国,关玲.中医药抗抑郁复方分析和证治规律研究[J].中国民间疗法,2004,12(2)：60-62.
[24]杨关林,王文萍,王健等.抑郁症中医证候的临床流行病学调查[J].辽宁中医杂志,2008,35(2)：180-181.
[25]《黄帝内经素问》.北京：人民卫生出版社,1963年.
[26]河北医学院校释.《灵枢经校释》.北京：人民卫生出版社,1982年
[27]元·朱震亨.《丹溪心法》.上海：上海科学技术出版社,1959年
[28]明·张介宾.《景岳全书》.北京：人民卫生出版社,1991年.
[29]宋·陈言.《三因极一病证方论》.上海：上海古籍出版社.1991年.
[30]明·虞传.《医学正传》.北京：人民卫生出版社,1965年.
[31]谢光.论“宣畅少阳”在治疗郁证中的应用[J].甘肃中医,1999,12(3)：2-3.
[1]马欢.抑郁症病因病机研究探析[J].辽宁中医杂志,2005,32(6)：537-538.
[2]徐琬梨,于文,刘国岩.肝气病探微[J].辽宁中医学院学报,2006,8(1)：22.
[3]刘宝录.解郁汤治疗隐匿性抑郁症31例体会[J].天津中医,1991,8(1)：326.
[4]刘紫凝,曹诗丹.浅议抑郁症从肺论治的中医理论基础[J].光明中医,2009,24(3)：399-400.
[5]于皎.辨证治疗抑郁症46例疗效观察及护理体会[J].河南中医,2006,26(3)：36-37.
[6]魏平,李煌,李予春.逍遥散加味治疗抑郁症30例[J].中医研究,1999,12(10)：54
[7]王旭高.医书六种.上海：上海科技出版社,1965：149—150.
[8]雷顺群.中医内科讲座[J].中国乡村医药杂志,2003,10(7)：67-68.
[9]邢协强,谢新年.抑郁症的中医辨症论治[J].医学临床研究,2003,20(7)：541-542.
[10]褚蔚.浅谈郁证从脾论治[J].国医论坛,2003,4(3)：15-16.
[11]尾崎哲,黄欣.小建中汤抗抑郁作用.国外医学中医中药分册,1993,15(5)：7-9.
[12]胡思荣.平心忘忧汤治疗抑郁症470例[J].湖北中医杂志,1996,18(121)：4-5.
[13]李玉岭,屈宝华,王为民等.保脑宁对焦虑抑郁行为临床疗效观察[J].中原医刊,1998,3(6)：41-42.
[14]王冠良,张爱军.郁证的辨证论治[J].菏泽医专学报,2002,14(4)：40-43.
[15]马瑞平,侯钦銮.女性抑郁症的中医辨治与调摄[J].浙江中医学院学报,2004,1 (28)：19-20.
[16]杜毅.滋肾舒郁汤加减治疗郁证[J].内蒙古中医药,2005,1(2)：16-17.
[17]唐启盛.颐脑解郁法治疗轻、中度抑郁症的开放性临床研究[J].中国临床康复,2002,21(6)：3207—3208.
[18]杨广林.宣肺法的临床运用[J].甘肃中医,2001,4(9)：40—42.
[19]韩晶杰,烟建华.从肺论治抑郁症的思路探讨[J].中华中医药杂志,2005,20(6)：349-350.
[2]中华医学会精神学会.中国精神障碍分类与诊断标准第三版(CCMD-III).济南：山东科学技术出版社,2001,第一版：87-89.
[3]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：214.
[4]American Psychiatric association, Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ), Washington DC,1994.
[5]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：223.
[6]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：292.
[7]张作记.行为医学量表手册.北京：中华医学电子音像出版社.2005,第一版：213.
[8]国家中医药管理局.中华人民共和国中医药行业标准·中医病证诊断疗效标准.北京：南京大学出版社,1994：20—21.
[9]国家技术监督局.中华人民共和国国家标准中医临床诊疗术语·证候部分.北京：中国标准出版社,1997：18,23,30-31,37-38.
[10]Mohammadi MR, Davidian H, Noorbala AA etal. An epidemiological survey of psychiatric disorders in Iran. Clin Pract Epidemoilment Health,2005, 26; 1:16.
[11]王红霞,张会嚣,吕红梅.围绝经期妇女抑郁症状及其影响因素探讨[J].护理学杂志,2005,20(18)：66-67.
[12]于皎.辨证治疗抑郁症46例疗效观察及护理体会[J].河南中医,2006,26(3)：36-37.
[13]郑开梅,武成,薛蕾等.抑郁症中医证候学临床流行病学调查[J].天津中医药大学学报,2006,25(3)：170-171.
[14]Nolen—Hoeksema. Genderdifference in coping with depression across the lifespan[J]. Depression,1995, (3):81-90.
[15]袁静,李坚.女性抑郁症相关因素的研究进展[J].中国妇幼保健,2007,25 (22)3609-3611.
[16]马欢.抑郁症病因病机研究探析[J].辽宁中医杂志,2005,32(6)：537-538.
[17]PattenSB. Incidence of major depression in Canada.Canadian Medical Association 2000:163:74-5.
[18]Sandra Harris.Abnormal Psychology:The problem of Maladaptive Be-havioral (Media and Research Update) 10th ed. New Jersey:Pearson Edu-cation 2004:10-11.
[19]王瑞红.大学生双性化人格特质与情绪状态的相关研究[J].山东省青年管理干部学院学报,2005,22(1)：49—50.
[20]Poli P, Sbrana B, Marcheschi M, etal. Self-reported depressive Symptoms in a school sample of Italian children and adolescents. Child Psychiatry Hum Dev 2003W33 (3):20-26.
[21]陈文垲,周玲,梅晓云等.571例抑郁症中医证候学临床流行病学调查[J].浙江中医杂志,2007,42(5)：262-264.
[22]王世宏.谢兆丰老中医治疗五脏郁证的经验[J].江苏中医,1996,17(1)：7-8.
[23]畅洪升,王庆国,关玲.中医药抗抑郁复方分析和证治规律研究[J].中国民间疗法,2004,12(2)：60-62.
[24]杨关林,王文萍,王健等.抑郁症中医证候的临床流行病学调查[J].辽宁中医杂志,2008,35(2)：180-181.
[25]《黄帝内经素问》.北京：人民卫生出版社,1963年.
[26]河北医学院校释.《灵枢经校释》.北京：人民卫生出版社,1982年
[27]元·朱震亨.《丹溪心法》.上海：上海科学技术出版社,1959年
[28]明·张介宾.《景岳全书》.北京：人民卫生出版社,1991年.
[29]宋·陈言.《三因极一病证方论》.上海：上海古籍出版社.1991年.
[30]明·虞传.《医学正传》.北京：人民卫生出版社,1965年.
[31]谢光.论“宣畅少阳”在治疗郁证中的应用[J].甘肃中医,1999,12(3)：2-3.
[1]马欢.抑郁症病因病机研究探析[J].辽宁中医杂志,2005,32(6)：537-538.
[2]徐琬梨,于文,刘国岩.肝气病探微[J].辽宁中医学院学报,2006,8(1)：22.
[3]刘宝录.解郁汤治疗隐匿性抑郁症31例体会[J].天津中医,1991,8(1)：326.
[4]刘紫凝,曹诗丹.浅议抑郁症从肺论治的中医理论基础[J].光明中医,2009,24(3)：399-400.
[5]于皎.辨证治疗抑郁症46例疗效观察及护理体会[J].河南中医,2006,26(3)：36-37.
[6]魏平,李煌,李予春.逍遥散加味治疗抑郁症30例[J].中医研究,1999,12(10)：54
[7]王旭高.医书六种.上海：上海科技出版社,1965：149—150.
[8]雷顺群.中医内科讲座[J].中国乡村医药杂志,2003,10(7)：67-68.
[9]邢协强,谢新年.抑郁症的中医辨症论治[J].医学临床研究,2003,20(7)：541-542.
[10]褚蔚.浅谈郁证从脾论治[J].国医论坛,2003,4(3)：15-16.
[11]尾崎哲,黄欣.小建中汤抗抑郁作用.国外医学中医中药分册,1993,15(5)：7-9.
[12]胡思荣.平心忘忧汤治疗抑郁症470例[J].湖北中医杂志,1996,18(121)：4-5.
[13]李玉岭,屈宝华,王为民等.保脑宁对焦虑抑郁行为临床疗效观察[J].中原医刊,1998,3(6)：41-42.
[14]王冠良,张爱军.郁证的辨证论治[J].菏泽医专学报,2002,14(4)：40-43.
[15]马瑞平,侯钦銮.女性抑郁症的中医辨治与调摄[J].浙江中医学院学报,2004,1 (28)：19-20.
[16]杜毅.滋肾舒郁汤加减治疗郁证[J].内蒙古中医药,2005,1(2)：16-17.
[17]唐启盛.颐脑解郁法治疗轻、中度抑郁症的开放性临床研究[J].中国临床康复,2002,21(6)：3207—3208.
[18]杨广林.宣肺法的临床运用[J].甘肃中医,2001,4(9)：40—42.
[19]韩晶杰,烟建华.从肺论治抑郁症的思路探讨[J].中华中医药杂志,2005,20(6)：349-350.