吴敏 黄敏娜

【摘 要】 乳腺癌是女性常见的一种恶性肿瘤，病程中常见并发抑郁症。中医认为其病位主要在肝，疏肝解郁法治疗乳腺癌并发抑郁症疗效显著，借助现代医学手段分析其显效的机制，进一步证实中医药在乳腺癌并发抑郁焦虑症中的作用。文章通过Pubmed、CNKI进行文献检索，对乳腺癌与抑郁的关系，情志与肝的关系，疏肝解郁治疗抑郁的机制、临床应用进行总结，以期为临床治疗乳腺癌并发抑郁提供依据。

【关键词】 乳腺癌;抑郁;情志;疏泄

【中图分类号】R737.9 【文献标志码】 A 【文章编号】1007-8517（2021）13-0085-04

Abstract：Breast cancer is a common tumor occurring in women， which is prone to complicated with depression. Traditional Chinese medicine held the opinion that the depression syndrome is mainly located in the liver. Clinical practice has proved that soothing the liver is effective in the treatment of breast cancer complicated with depression. With the help of modern medical means， the study to analyze its mechanism and confirm the role of Chinese medicine in breast cancer complicated with anxiety does great help to reduce the patient's psychological burden.By searching the Pubmed and the CNKI，this article summaried the studies on the association between breast cancer and depression，motion and liver， the mechanism of soothing the liver and its clinical use，so as to provide ideas for clinical treatment of breast cancer complicated with depression.

Keywords：Breast Cancer;Depression;Emotion;Soothing the Liver

乳腺癌在中國发病率位居女性恶性肿瘤中首位，而乳腺癌病人在疾病诊断和治疗全程均可能并发抑郁症，2017年SIO临床实践指南指出，乳腺癌伴发抑郁的有3%～34%，伴发焦虑的有12%～47%，且有11%～16%的患者同时伴有焦虑和抑郁症状[1]。研究[2]证实，抑郁症会进一步促使肿瘤恶化，极大降低患者治疗的依从性以及影响治疗效果，抑郁与乳腺癌死亡风险有较大的关系，抗抑郁治疗能够降低乳腺癌患者死亡风险。中医认为，情志对于乳岩的形成、转移与预后有着重要影响，而情志疾病的发生在于肝调畅气血不利，疏肝解郁法在临床中辅助治疗郁证，能够在早期进行干预，截断病程，有利于克服西药治疗的依赖性，且现代医学手段不断证实其干预途径，为疏肝解郁法治疗乳腺癌并发抑郁症提供更加有力的依据。

1 情志与乳腺癌的相关性

1.1 情志异常促进乳腺癌形成与恶化 近年来的研究[3]表……