| 引用本文: |
王嘉馨, 张永华, 胡霖霖.张永华教授治疗破坏性心境失调障碍经验[J].湖南中医药大学学报,2026,46(7):1439-1443[点击复制] |
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| 张永华教授治疗破坏性心境失调障碍经验 |
| 王嘉馨,张永华,胡霖霖 |
| (浙江中医药大学附属杭州市中医院, 浙江 杭州 310007) |
| 摘要: |
| 破坏性心境失调障碍（DMDD）是以持续易激惹和间歇性暴怒发作为核心特征的儿童青少年精神障碍，目前西医治疗存在个体差异大及家长接受度较低等问题。本文基于张永华教授创立的情志辨证理论体系，探讨DMDD的中医认识与治疗策略，通过对该病病因病机的系统分析，提出其基本病机为肝失疏泄，气机逆乱，易从火化，多兼痰浊，上扰心神，以致神明失和；临床可分为肝郁化火、痰火扰心、痰气郁结3种常见证型，治疗上以疏肝解郁、调畅气机为核心，兼以清火、化痰，随证治之。并附验案一则，以资佐证。张永华教授提出的情志辨证理论体系，为临床诊疗DMDD提供清晰的辨证框架和治法路径。 |
| 关键词: 情志辨证理论体系|破坏性心境失调障碍|临证经验|肝郁化火|痰火扰心|痰气郁结|张永华 |
| DOI：10.3969/j.issn.1674-070X.2026.07.016 |
| 投稿时间：2026-03-28 |
| 基金项目:浙江省中医药科技计划项目（2022ZB246）。 |
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| Professor ZHANG Yonghua's experience in treating disruptive mood dysregulation disorder |
| WANG Jiaxin, ZHANG Yonghua, HU Linlin |
| (Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310007, China) |
| Abstract: |
| Disruptive mood dysregulation disorder (DMDD) is a psychiatric disorder affecting children and adolescents, characterized by persistent irritability and recurrent severe temper outbursts. Current Western medical treatments are limited by considerable interindividual variability in therapeutic response and relatively low parental acceptance. Based on the theory of emotion-based pattern differentiation established by Professor ZHANG Yonghua, this paper discusses the Chinese medicine understanding and therapeutic strategies for DMDD. Through a systematic analysis of etiology and pathogenesis of the disorder, the fundamental pathogenesis is considered to involve failure of the liver to govern the free flow of qi, resulting in disordered qi movement that readily transforms into fire, often accompanied by phlegm turbidity ascending to disturb the heart spirit, thereby causing disharmony of the bright spirit. Clinically, three common patterns can be identified: liver qi stagnation transforming into fire, phlegm fire disturbing the heart, and phlegm qi stagnation. The treatment focuses on soothing the liver and relieving stagnation, regulating qi movement, and is supplemented by clearing fire and resolving phlegm with treatment modified according to specific pattern. A representative clinical case is presented as supporting evidence. Professor ZHANG Yonghua proposes that the theory of emotion-based pattern differentiation provides a clear framework for pattern differentiation and therapeutic strategies in the diagnosis and treatment of DMDD. |
| Key words: emotion-based pattern differentiation theory|disruptive mood dysregulation disorder|clinical experience|liver qi stagnation transforming into fire|phlegm fire disturbing the heart|phlegm qi stagnation|ZHANG Yonghua |
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