双相情感障碍患者发病时相症状的运气特征

Distribution of Circuits and Qi Characteristics of Symptomatic Phases in Patients with Bipolar Disorder

摘要:

目的：探讨双相情感障碍（BD） 患者发病时相的五运六气特征，为BD患者发病病机本质寻找新 的切入点。方法：选取1990—2020年厦门市仙岳医院收治的BD住院患者2 155例，根据患者发病时相特点， 将其分为躁狂相组及抑郁相组；同时依据发病期间是否伴有精神病性症状，进一步将躁狂相分为伴精神病性症 状组（躁狂伴精组） 859例、不伴精神病性症状组（躁狂不伴精组） 920例，将抑郁相分为伴精神病性症状 组（抑郁伴精组） 92例、不伴精神病性症状组（抑郁不伴精组） 220例。分别对BD患者的发病日期进行运气 转化，并对其发病日期的运气分布进行统计学分析。结果：躁狂相中伴精组与不伴精组在客气分布上差异有统 计学意义（P＜0.05），在岁运、主运、客运、主气分布上差异无统计学意义（P＞0.05）；抑郁相中伴精组与不 伴精组在主运分布上差异有统计学意义（P＜0.05）；在岁运、客运、主气、客气分布上差异无统计学意 义（P＞0.05）。结论：BD患者躁狂相的精神症状可能与厥阴风木客气有关，不伴有精神病性症状的躁狂相可 能与少阴君火客气有关；BD患者抑郁相的精神症状可能与太木主运有关，不伴有精神病性症状的抑郁相可能 与少土、太火主运有关。在五运六气视角下，BD患者精神病性症状的出现可能是厥阴风木或木运太过引动肝 风，挟实邪致神机失用的严重状态。

Abstract:

Abstract： Objective： To explore the Five Circuits and Six Qi characteristics of the symptomatic phases in patients with bipolar disorder （BD），aiming to identify new entry points for understanding the underlying pathogenesis of BD. Methods：A total of 2 155 BD inpatients treated at Xiamen Xianyue Hospital from 1990 to 2020 were selected. Based on the symptomatic phases at onset， patients were divided into manic phase and depressive phase groups. According to the presence or absence of psychotic symptoms during the onset period，the manic phase group was further subdivided into a group with psychotic symptoms （n=859） and a group without psychotic symptoms （n=920）. Similarly， the depressive phase group was subdivided into a group with psychotic symptoms （n=92） and a group without psychotic symptoms （n=220）. The onset dates of BD patients were converted into Five Circuits and Six Qi data， and statistical analysis was performed on the distribution of these parameters. Results：In the manic phase，the distribution of guest qi showed a significant difference between the group with psychotic symptoms and the group without psychotic symptoms （P＜0.05）. However， no significant differences were observed in the distributions of annual circuit， host circuit，guest circuit，or host qi between the two groups （P＞0.05）. In the depressive phase，the distribution of host circuit showed a significant difference between the group with psychotic symptoms and the group without psychotic symptoms （P＜0.05）. However， no significant differences were observed in the distributions of annual circuit， guest circuit，host qi，or guest qi between the two groups （P＞0.05）. Conclusion：Psychotic symptoms in the manic phase of BD may be associated with guest qi of Reverting Yin Wind-Wood. Manic phases without psychotic symptoms may be related to guest qi of Lesser Yin Sovereign Fire. Psychotic symptoms in the depressive phase of BD may be associated with the excessive host circuit of Greater Wood. Depressive phases without psychotic symptoms may be related to the host circuits of Lesser Earth and Greater Fire. From the perspective of Five Circuits and Six Qi，the emergence of psychotic symptoms in BD patients may be a severe condition where Reverting Yin Wind-Wood or excessive Wood circuit stirs liver wind，combined with excess-pathogens，leading to deactivation of the vital activity.