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全生讲中医 (19)—神经衰弱的中医防治(8/31/2011)

神经衰弱是指由于长期的情绪紧张和精神压力,从而导致精神活动能力减弱的一种病症。该病患者主要表现为易于兴奋又易于疲劳,常伴有各种躯体不适感和睡眠障碍,很多患者都具有某种易感素质或不良个性。大多数病例发病于16-40岁之间,两性发病数无明显差异。从事脑力劳动者占多数。本病如处理不当可迁延达数年甚或数十年, 严重影响生活质量。
 
       目前大多数学者认为精神因素是造成神经衰弱的主因。凡是能引起持续的紧张心情和长期的内心矛盾的一些因素,使神经活动过程强烈而持久的处于紧张状态,超过神经系统张力的耐受限度,即可发生神经衰弱。如过度疲劳而又得不到休息是兴奋过程过度紧张;对现在状况不满意则是抑制过程过度紧张;经常改变生活环境而又不适应,是灵活性的过度紧张。
 
       本病的诱因多,起病慢,临床表现错综复杂。主要表现为神经精神症状如精神疲劳,神经过敏,失眠,焦虑和忧郁,工作耐力差,易于疲劳,记忆力减退,头晕脑胀,失眠多梦,情绪不稳和自主神经功能紊乱,其次是特定的脏腑症状如口淡无味,食欲不振,胁痛腹胀,恶心嗳气,便干或便溏,心悸胸闷气短,面红耳赤或面色无华,畏寒怕冷或虚热烦躁,性欲异常或阳萎遗精,月经失调,其特点是病人痛苦万分,自述症状繁多,而医生检查很少客观体征,一般无器质疾病能够发现。
 
        神经衰弱一般采用中西医结合治疗. 神经衰弱属中医“不寐”、“健忘”、“惊悸”等病证范畴,中医根据临床表现一般分为肝气郁结、肝肾阴虚、心脾亏虚、阴虚火旺、肾阳不足等证型。因此在治疗时,以疏肝解郁, 健脾益气, 养心安神, 调整阴阳为主要方法。具体用药时又要注意,清热不宜过于苦寒,祛寒不宜过于辛热,更不要随便用攻伐的药物。
 
         北京中医药大学名老中医程士德教授,全国百名名老中医之一,积70余年临床经验,对关节痹痛、咳嗽、胃脘痛、闭经、、不孕不育、失眠、抑郁等精神情志失调性疾病和过敏性疾病等疑难杂证有丰富的理论和经验。作者有幸跟随程老坐诊三年,治愈神经衰弱病人多例. 今抄录当时病案一例, 展程老辨痼疾于指端, 起沉疴于平凡之特色.
 
一徐性女子,31岁,有纳谷不香, 胃中不适, 头晕乏力, 失眠多梦,记忆力减退, 精神恍惚五年余, 舌淡苔白, 脉细弱。程老根据辩证,治以健脾益气,养心安神。药用:太子参,炒白术,茯苓,陈皮,半夏,木香, 竹茹,白蔻,焦三仙,香橼皮 , 酸枣仁, 各10g, 炒山药20g,砂仁6g. 治疗一月余, 食佳眠香, 诸症皆消.
 
           针灸对于神经衰弱的防治,疗效很好。但需根据辩证,采用不同组穴,方可取得满意效果。同时,让患者看淡凡事,知足长乐; 获得充分休息; 积极参加一些适当的体育锻炼,如跑步,散步,体操,气功,太极拳等, 对改善神经衰弱诸症有帮助。
 
         几首小方,对神经衰弱有帮助。甘麦饮:小麦30克,红枣10枚,甘草10克,水煎服, 每日早晚各服1次. 莲子百合粥:莲子、百合粳米各30克同煮粥,每日早晚各服1次。杞枣汤:枸杞子、桑椹子、红枣各等份,水煎服,早晚各1次。
 
        下期敬请关注头痛的中医防治. 更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-919-9898, 301-340-7682约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850 (1个街区到Rockville地铁站,免费停车). 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902 (2分钟走到Forest Glen 地铁站).

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