With the continuous development of the material and spiritual civilization of society, the issue of mental health has attracted more and more attention from the international community, and the state of mental health of the people and the means of prevention and treatment of mental disorders have a great bearing on the physical and mental health of the broad masses of the people and the prosperity and development of society.
Vigorously carrying out and popularizing the prevention and treatment of mental health has become one of the important tasks of modern medicine. As one of the most common mental disorders, the pathogenesis of schizophrenia (SZ) is still unclear, and the incidence of schizophrenia is more common than that of young adults.
Schizophrenia can be classified as "epilepsy" in Chinese medicine according to the "People's Republic of China Traditional Chinese Medicine Industry Standard - Diagnostic Efficacy Standards for Traditional Chinese Medicine Diseases".
There is a cloud in "The Twenty Difficulties of the Classics": "Those who are heavy yang are crazy, and those who are heavy yin are crazy", which corresponds to the two types of clinical symptoms of common schizophrenia summarized by modern Western medicine, and the positive symptoms correspond to the negative symptoms.
Positive symptoms are often manifested as: manic riots, moodiness, scolding and destroying objects, etc., which are characterized by excessive excitement of mental activities, while negative symptoms are characterized by excessive inhibition of mental activities, often manifested as: apathy, negative self-pity, self-talk and self-laughter, etc.
"Jingyue Quanshu" once mentioned: "Epilepsy is mostly caused by phlegm, where the qi is reversed, and the phlegm is stagnant, the meridians can be closed, and the heart can be stopped." Therefore, the occurrence and development of epilepsy is inseparable from "phlegm", and phlegm is obsessed with phlegm, blinding the gods or turning into fire in depression, making the rebellion of the divine machine the key pathogenesis.
Since the Song, Jin and Yuan dynasties, there have been many doctors who have taken the phlegm dissolving method as the main treatment of epilepsy, such as Cheng Zhongling's prescription in the "Medical Understanding", which selects the medicinal materials that clear heat and dissolve phlegm, calm the heart and calm the nerves, such as: Stone calamus and gallant Nanxing to treat epilepsy with clear heart and phlegm.
"Danxi Heart Method: Madness" pointed out: "Madness belongs to yin, madness belongs to yang, madness is more joy and madness is more angry, and those with weak pulse can be cured, but in fact they die." Most of the phlegm is knotted in the heart and chest, and the treatment should calm the mind and open the phlegm. It also clarified that expectorant opening is the main treatment policy for epilepsy.
Through recent studies, it has been found that patients with schizophrenia are more likely to suffer from metabolic diseases than the general population, especially the prevalence of abnormal glucose and lipid metabolism is significantly higher than that of the general population, and the main reasons are: patients have less daily physical exercise, drug side effects caused by long-term use of antipsychotic drugs, and congenital genetic factors.
This type of metabolic syndrome belongs to the category of "phlegm dampness" in traditional Chinese medicine, that is, the lipids in the blood are too high, or it is called lipid mixture. Studies based on the constitution theory of traditional Chinese medicine have shown that the risk of cardiovascular, cerebrovascular, endocrine-related diseases such as coronary heart disease, hypertension, stroke, gout, hyperlipidemia, and diabetes is significantly higher in people with "phlegm-damp constitution" than those without "phlegm-damp constitution".
By studying the gene expression profile of the peripheral blood of these people, it was found that the peripheral blood cells of this group had the overall characteristics of metabolic disorders at the molecular level, with the abnormalities of lipid metabolism-related genes and glucose metabolism-related genes as the main manifestations.
At present, it is generally believed that the abnormal elevation of triglycerides, cholesterol, low-density lipoprotein content and other laboratory indicators is the unique marker and material basis of phlegm-dampness.
Clinically, for patients with schizophrenia with abnormal lipid metabolism and high blood lipids, most of the clinical methods are to change antipsychotic drugs or lifestyle interventions combined with oral hypolipidemic drugs to alleviate the toxic side effects of related drugs.
However, these methods are also easy to cause patients with schizophrenia to reduce their treatment compliance and excessive oral medication, and once the drug is stopped, blood lipids are easy to rebound, which reduces the quality of life and survival of patients with schizophrenia.
Therefore, there is still a lack of effective and regular solutions at home and abroad. Acupuncture has entered our field of vision as a treatment method with few side effects and safe and convenient operation, and combined with clinical observation in recent years, acupuncture has also achieved remarkable results in the treatment of schizophrenia.
Among them, the use of the old Chinese medicine to summarize the experience of acupuncture "first eight injections" to improve the quality of life and health status of patients with schizophrenia, and reduce the adverse reactions caused by long-term oral antipsychotic drugs, which has played a positive role in helping and promoting the physical and mental recovery of patients.
At the same time, acupuncture has a significant effect on improving the sleep quality, quality of life and health status of patients with schizophrenia.
Through clinical studies, it was found that there was a significant difference in the Pittsburgh Sleep Quality Index (PSQI) between the first acupuncture treatment group before and after treatment, and the patients' sleep conditions were significantly improved and their sleep quality improved.
Schizophrenia (SZ) is one of the most common mental diseases, with an incidence of about 1% in the global population, and its clear cause is still unclear.
The number of inpatients with schizophrenia in mainland China accounts for more than 50% of the total number of hospitalizations for patients with mental illness. Back in the mid-90s, the World Health Organization (WHO) survey on the global burden of disease showed that the burden of several common mental disorders, such as schizophrenia, was among the highest.
According to the 2006 epidemiological survey of schizophrenia in mainland China, the total population of patients in mainland China has reached about 100 million, and it is showing a continuous increasing trend, and the mainland's expenditure on the prevention and treatment of mental diseases accounts for 1% of GDP, far exceeding that of many chronic diseases.
Studies have shown that schizophrenia, as a recurrent chronic mental illness, is more common between the ages of 15 and 35, and it has a familial genetic tendency, which is affected by physiological, psychological, environmental factors, social support, congenital heredity and other aspects and their interactions.
Patients often show symptoms of abnormal mental activity, such as sensory and perceptual disorders, thinking disorders, emotional disorders, volitional and behavioral disorders, cognitive dysfunction, and in severe cases, harmful sexual behaviors and other adverse consequences, causing serious damage to the harmony and stability of the family and society.
At present, the prevention and treatment of schizophrenia has become a national key research and development project, and the clinical treatment of patients with schizophrenia mostly adopts a combination of psychological intervention and drug control, and establishes three-level prevention and control measures to reduce the occurrence of key mental diseases such as schizophrenia, and reduce their harm and social function damage.
Schizophrenia can be classified as a category of madness in traditional Chinese medicine, and according to its typical clinical manifestations, it can be divided into type I schizophrenia with positive symptoms corresponding to the "madness" of traditional Chinese medicine.
The other is type II schizophrenia, which is mainly negative symptoms, corresponds to the "epilepsy" of traditional Chinese medicine, and its main symptoms are: emotional apathy, speech poverty, motor stiffness, etc., often accompanied by cognitive changes or disorders.
Although the clinical manifestations of the two diseases are different, they can often be transformed into each other and alternate repeatedly. The name of the disease of epilepsy was first seen in the "Yellow Emperor's Neijing", also known as "epilepsy", and the original text also listed the pattern characteristics and clinical manifestations of the occurrence and development of the disease.
In the early stage of epilepsy, patients often have emotional abnormalities such as sullenness, followed by physical discomfort symptoms such as headaches, direct eye vision, redness and bleeding in both eyes, and after these symptoms continue to worsen, the patient eventually appears upset and trance.
Another article says: "Madness is born, first self-sorrow, joy and forgetfulness, anger and fear, the sorrow and hunger." It refers to the fact that during the attack of mania, the patient often feels sad, and then due to emotional sorrow or hunger, it is easy to cause forgetfulness, anger, and fear.
If the course of the disease is further aggravated without intervention, clinical symptoms such as verbal arrogance and abnormal behavior will occur. In addition, there is a cloud in "The Twentieth Difficulty": "Those who are heavy yang are crazy, and those who are heavy yin are crazy", which also briefly describes the different clinical manifestations and pathogenesis of epilepsy and madness.
The subject of the study was phlegm-damp schizophrenia, and most of the patients were in a stable condition, which belonged to the category of "epilepsy" in traditional Chinese medicine, which was evidence of "the truth of the truth".
The relevant provisions of "Danxi Heart Law - Madness" also demonstrate the important relationship between "epilepsy" and "phlegm", clarifying that phlegm is an important cause of epilepsy, and treating phlegm is its main treatment principle.
Most of the phlegm is knotted in the heart and chest, and the treatment should calm the mind and open the phlegm. The original text of "Lingshu Madness" also mentions many times that the clinical manifestations of epilepsy patients are "vomiting and salivating", which is also a sign of qi stagnation and phlegm coagulation, so dissolving phlegm, reducing turbidity and dispeling dampness is one of the important means for the treatment of epilepsy.
To sum up, epilepsy is mainly located in the heart and brain, and is closely related to the liver, gall bladder, spleen and other viscera. The pathological nature is the interaction of the four pathological factors of qi, fire, phlegm and stasis, which are combined with each other and then cause the onset of the disease.
In addition, innate endowment and emotional factors also affect the occurrence, development and prognosis of epilepsy to varying degrees. Innate endowment is closely related to the onset of epilepsy.
Misnutrition in the fetus, or fright of the mother during pregnancy, great sorrow and joy, emotional fluctuations are too large to cause the fetus to be congenitally deficient in fetal gas, and the weak endowment leads to the dysfunction of its internal organs and the imbalance of yin and yang.
If the individual is usually yin and yang, quiet and introverted, he will hurt the spleen after thinking for a long time, the spleen will lose its health, and the qi will stagnate and stagnate, resulting in the loss of water and liquid transport, and the phlegm will be reversed and the gods will be blinded, or the seven emotions will be depressed for a long time, worry and anger, and the liver qi will be depressed and turn into fire, resulting in phlegm and fire intermingling, and the divine machine will be reversed and the disease will occur.
In addition, traumatic factors such as car and horse falls, fall injuries, or long-term onset of the disease, and stagnation of the veins, will make the qi, blood, and fluid unable to ascend, the brain is not nourished, and the delirium will eventually become epilepsy.
In recent years, studies have pointed out that acupuncture has a certain effect on the improvement of pathological symptoms, emotional control and psychological disorders in patients with schizophrenia, and most of the treatment regimens are acupuncture combined with low-dose anti-schizophrenic drugs, which not only reduces the distress of patients with more oral drugs, but also alleviates the adverse reactions caused by the drugs, and reduces the cost of medical expenses.
Traditional acupuncture treatments include: acupuncture, electroacupuncture, warm acupuncture, moxibustion, acupoint injection, acupoint embedding, auricular acupoint embedding and other methods. Among the many classic works of acupuncture and moxibustion, there are many examples of medical cases of thirteen ghost points to treat epilepsy recorded in the famous Tang Dynasty doctor Sun Simiao's "Preparation for Emergencies", such as "Acupuncture A and B Sutra": "Epilepsy and diseases are introduced to each other, and the ditch and gum are handed over to the master." ”
It is recorded in the "Acupuncture Shisheng Sutra": "With Da Lingzhi laughing more than once". In clinical research, many trials have emerged in the treatment of schizophrenia, and the results have been remarkable. The treatment of patients with schizophrenia (madness) was treated with strong stimulation of the thirteen ghost points, intermittent twisting, lifting and inserting needles, supplemented by tremor manipulation, and the treatment results were remarkable, and there was no recurrence during the follow-up period.
Looking at the twelve meridians, the ear is closely related to the following of many meridians: the hand and foot Shaoyang meridian, the hand and foot Yang Ming meridian, etc., and the holographic theory and Western medical anatomy also affirm the treatment basis of the auricular acupoint from the theory and structure.
By selecting the application and compression of Wang Buliuxing seeds in Shenmen, subcortex, spleen, kidney and other auricular acupoints, combined with olanzapine oral, compared with the efficacy of the simple olanzapine treatment group, it was found that the effective rate of improvement of depressive symptom scores in the auricular acupoint bean embedding group was significantly better than that of the control group, and the incidence of adverse reactions such as drowsiness, constipation, dry mouth and bitterness was lower.
The efficacy of bilateral Zusanli injection of chlorpromethel 25 mg and intramuscular chlorproma 50 mg in patients with acute schizophrenia was discussed. After 15 days of treatment, the incidence of impulsive behavior in the Zusanli injection group was significantly lower than that in the control group, the control effect of excitatory state was more stable, and the adverse reactions of chlorprofen were fewer.
A randomized controlled trial was designed to compare the clinical efficacy of haloperidol injection and oral risperidone tablets injected into Hegu and Zusanli, and it was found that both groups had good efficacy in improving the symptoms of schizophrenia after 8 weeks of treatment.
However, the acupoint injection group had a higher overall effective rate, and compared with previous studies using oral haloperidol tablets, it was found that there were fewer adverse reactions in the acupoint injection method, and the patient acceptance was higher.
Acupuncture therapy has been widely used in the treatment of many clinical diseases such as internal, external, gynecological, and pediatric diseases due to its efficacy, advantages and safety. In recent years, the efficacy of the treatment of mental diseases such as schizophrenia and depression has been gradually discovered and affirmed.