中医心理治疗案例分析

目的:了解中医心理诊断、治疗、详细情况。方法:选取历代中医书籍和现代期刊中记录的中医心理治疗案例共122例,分别从案例年代、性别、年龄、疗程、致病因素、中医诊断、中医心理治疗方法、合并治疗方案、现代诊断、现代治疗分类以及有无违背伦理学原则等11个方面进行统计。结果:案例年代从唐代以前至近现代时期均有,其中男女比例相当,年龄0~50岁,疗程1天~1年以上58例(47.54%);治疗当天病情就获得缓解的占47.54%,1个月之内缓解的占68%。59例发病与情志刺激有关,其中,"忧"、"思"致病为最多,分别为10.66%和11.48%。疾病诊断多为癫狂、郁证等精神科疾病以外的内科杂症(心身疾病),占55.74%,在精神疾病中,以郁证为最多,约占总数的1/5。心理治疗方法中使用最多的依次是情志相胜法(19.67%)、暗示解惑法(14.75%)、激情疗法(12.30%)、劝说开导法(9.84%)、顺情从欲法(8.20%)和行为诱导法(9.02%)等,有31.97%的案例合并药物或针灸治疗。按现代诊断分别为神经症(16.39%)、应激相关障碍(10.66%)和癔症(8.20%)。有近一半(46.72%)的案例所使用的心理治疗方法,与现代心理治疗的某些理论一致,如支持治疗、行为治疗、认知治疗等,另有一些属于中医独特的治疗方法,如情志相胜治疗。共有22例(18%)的案例中使用了有悖于伦理的方法。结论:中医心理治疗是一种有效的短程心理治疗,主要适用于神经症、应激相关障碍、癔症等精神障碍,具有明显的中国文化特色,值得挖掘和推广。

A Study of Cases Analysis with Psychotherapy of Traditional Chinese Medicine

Objective: To explore the information of diagnosis and treatment of psychotherapy of TCM.Method:The record of 122 cases receiving psychotherapy of TCM were obtained from the literatures at ancient time and current magazines,and 11 aspects including occurring era,gender,age,course,causative factors,TCM diagnosis,TCB psychotherapy,concomitant treatment strategy,current diagnosis,current therapy classification and whether breaching ethic rules,were evaluated.Results: The cases occurred from Tang Dynasty to current time,with age range from 0 to 50 years old and course from 1 day to more than 1 year,58% of which got relieved at the first day of treatment,and 68% relieved within 1 month.The 59 patient onsets resulted from emotional stimulation,especially "YOU(Anxiety)" and "SI(Thought)" occupying 10.66% and 11.48% respectively.The diagnosis of the diseases mainly included psychosomatic diseases except psychiatric diseases such as Dian,Kuang,Depressed syndrome,etc.,occupying 55.74%.The maximum of the mental diseases was depressed syndrome,occupying 1/5.The mostly applied psychotherapies included Emotion Inter-resistance Therapy,(19.67%),Suggestive Explanation Therapy(14.75%),Intense emotion Therapy(12.30%),Persuasion and Release Therapy(9.84%),Smoothing emotion and desire Therapy(8.20%),Behavioral Induction Therapy(9.02%),etc.,and 31.9% of cases were accompanied with drug or acupuncture therapy.The current diagnosis included neurosis(16.39),stress-related disorder(10.66%) and hysteria(8.20%).The nearly half of psychotherapies applied(46.72%) were consistent with some theories of modern psychotherapy,such as Supportive Therapy,Behavioral Therapy,Cognitive Therapy,etc.,and some therapies such as Emotion Inter-resistance Therapy belonged to unique treatments of TCM.Among all cases,22 cases(18%) might breach the ethic rules.Conclusion: Psychotherapy of TCM was an effective short-term psychotherapy,and was mainly applied for some mental disorders including neurosis,stress-related disorder,hysteria,etc.,which had obvious Chinese culture distinctness and deserved development and extension.