黄强 陆巳寓 许欢 万兴 张仕年

[摘要]廣泛性焦虑症（GAD）是临床常见的精神类慢性疾病，其发病率近年来呈上升趋势，严重影响人们的身体健康和生活质量。本文梳理了中国知网和万方数据库从2016年5月至2021年5月发表的中医药治疗 GAD 的研究文献，从其病因病机、辨证分型、治疗方法等方面总结了近5年来中医药在该领域的研究近况。结果表明 CAD 临床多见虚实夹杂，脏腑功能失衡、气机运行不畅、虚火躁扰心神、痰浊上蒙清窍为本病主要病机，中医辨证分型以脏腑辨证为主，中医治疗的主要方法有中药内服、针刺、推拿等，其临床疗效显著且远期疗效优于西药治疗，同时指出目前临床研究仍存在数据量不足、中医辨证分型繁杂及缺乏客观评价指标等问题，希冀为本病今后的治疗和科研提供参考。

[关键词]广泛性焦虑症;中医治疗;中药;针刺;推拿;研究进展

[中图分类号] R749.7+2  [文献标识码] A   [文章编号]2095-0616（2021）24-0066-05

Progress of the research on treating generalized anxiety disorder with traditional Chinese medicine

HUANG  Qiang1      LU  Siyu1      XU  Huan1      WAN  Xing2      ZHANG  Shinian2

1. Affiliated Hospital of Nanjing University of Chinese Medicine， Jiangsu， Nanjing 210000， China;2. Department of Massage， Jiangsu Province Hospital of Chinese Medicine， Jiangsu， Nanjing 210000， China

[Abstract] Generalized anxiety disorder （GAD） is a common chronic mental disease in clinical practice， and its incidence is on the rise in recent years， which has severely degraded people's physical health and quality of life. In this paper， the research literature on treating GAD with traditional Chinese medicine （TCM） published by CNKI and Wanfang database from May 2016 to May 2021 was reviewed， and the research progress of TCM in this field in recent five years was summarized from the perspectives of etiology and pathogenesis， syndrome differentiation and classification， and treatment methods， etc. According to the results， clinical inclusion of deficiency and excess is common for CAD， and the main pathogenesis of this disease includes the imbalance of zang-fu organs' function， disturbance of qi movement， the irritability of deficiency fire disturbing the heart and mind， and phlegm clouding clear orifices. Syndrome differentiation and classification of TCM is mainly based on syndrome differentiation of zang-fu organs. The main TCM treatments are oral administration of TCM， acupuncture and massage， etc.， whose clinical effect is significant and the long-term effect is better than that of Western medicine treatment. Moreover， in this paper it is pointed out that at present there are still some problems in clinical research such as insufficient data， complicated TCM syndrome differentiation and classification， and lack of objective evaluation indices， etc.， which is meant to provide reference for the treatment of this disease and the relevant research in the future.

[Key words] Generalized anxiety disorder; TCM treatment; Chinese materia medica; Acupuncture; massage; Progress of the research

广泛性焦虑症（generalized anxiety disorder， GAD）属于焦虑障碍的一种常见亚型，具有发病持久、广泛的特点，主要表现为过度焦虑、自主神经功能紊乱和运动性不安，临床常见睡眠障碍、神经性头疼、神经衰弱、肌张力增高、过分紧张、心悸、汗出等症状[1]。研究显示[2]，GAD 的终身患病率约为5%，以青中年女性最为多见，呈现女多男少的特点。目前，较公认的抗焦虑方法以西药治疗和心理干预为主。5-羟色胺再摄取抑制剂是世界精神病協会首要推荐的治疗药物，但以 SSRI 为代表的西药治疗，存在不良反应明显、患者长期服药依从性差等缺点[3]。……