Analysis and reflection on the current status of Chinese medicine research on affective disorders

Chinese medicine has always attached importance to the influence of emotions on health and disease, as early as in the period of the "Neijing" that is, the name of the evidence of emotional illness, etiology and treatment of the preliminary understanding, adhering to the purpose of the "Neijing", successive generations of medical doctors have enriched and developed the doctrine of emotional illness, laying the foundation for the study of the present emotional illnesses. In recent years, with the changes in the living environment of modern society, the accelerated pace of people's work and life, and the aggravation of various stress factors, the incidence of many mood disorders caused by social, psychological and other factors is increasing, and they have become a hidden danger that threatens people's physical and mental health. Chinese medicine theory of emotion and will because of its emphasis on the human body physiology, psychology and social, environmental integration of the holistic view, a good fit with the modern biological, psychological, social, environmental medicine model, and in the prevention and treatment of emotion and will of the disease in the body and mind and treatment of the advantages, so in recent years doubled the attention of the world as one of the important topics of research in the field of traditional Chinese medicine. The following theoretical and experimental studies analyze and reflect on the current status of Chinese medicine research on affective disorders.

1 Theoretical study

1.1 Connotation of emotion and emotion-centeredness

The term "emotion and centeredness" originated from the Neijing's discussion of emotion and five chi, which is the abbreviation of the seven emotions and five chi by later generations of medical doctors. Modern scholars have different academic opinions on the meaning of emotion and will: Basic Theory of Traditional Chinese Medicine states that emotion and will is the mental state of the organism, which is the seven different emotional reflections made by the human body to objective external things and phenomena. Jin Guangliang [1] believes that the mood is an inner experience, is under the role of external stimuli, through the induction of the heart and spirit, the five visceral essence changes and produces a certain tendency to attitude performance. Wu Gang [2] believes that emotion and will is the state of mind of the organism, the organism in the mind under the domination and regulation of the five visceral essence as a material condition, in the external environment under the stimulation and influence, through the internal and external comprehensive effect on the objective things produced by a special form of reflection, is a person for the objective things to satisfy their own desires and the experience produced. Qiao Mingqi et al [3] study pointed out that: the mood is the unique title of Chinese medicine to the modern sense of emotion, the word itself contains the mood experience and mood expression, by contemporary medical application development, the concept of mood has been embedded in the modern sense of the main connotations of the emotions; the body's state of mind, does not belong to the heart and spirit, not to be confused with the divine spirit, it is a complex reaction involving the psychological, physiological two systems; the experience, the expression and the accompanying physiological and behavioral changes are the main connotations of emotions. Li Huiji [4], Song Weixi et al [5] that, emotion and Zhizhi refers to the seven emotions and five Zhizhi, but also involves the content of the five gods, which includes the modern psychology of emotions, feelings, passions and wills and other psychological processes, but also related to the personality psychological characteristics, is a generalization of the modern psychology of a variety of psychological factors.

In the understanding of Chinese medicine, many of the evidence of disease are related to the seven emotions, therefore, the emotions cause a wide range of diseases, Lai Kai [6] pointed out that nearly 50 kinds of Chinese medicine internal medicine evidence, palpitations, insomnia, syncope, depression, epilepsy, epilepsy, headache, vertigo, stroke and many other kinds of evidence of disease can be directly by the abnormalities of the emotions and feelings caused by coughing, wheezing, pectoral paralysis, stomach ache, vomiting, eructation, diarrhea, constipation, dropsy, etc. Quite a few Many of these diseases are also related to abnormalities of emotion and will. Li Huiji et al [4] believe that the emotional disease refers to the process of disease occurrence, development and regression, emotional factors play a major role in a class of diseases, including mental diseases, psychosomatic diseases, psychological diseases, neurological diseases and all functional diseases. According to Xu Zhiwei [7], the disease evidence of emotion and will is caused by the seven emotions and internal injuries and the main feature of the disease evidence of emotional activity disorders, including those caused by the internal injuries of emotion and will: a class of diseases mainly with the symptoms of spirit and mind, such as: depression, dirty mania, insomnia, epilepsy, etc.; a class of diseases mainly with the symptoms of the form and body, similar to the modern medicine said that the psychosomatic diseases, widely involved in internal, external, gynecological and pediatrics a variety of disorders, such as: asthma, choking, choking septum, The Chinese medicine of emotional illness includes the modern medicine of psychosomatic diseases, neuroses and mental illnesses, etc.

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The Chinese medicine of emotional illness includes the modern medicine of psychosomatic diseases, neuroses and mental illnesses.

1.2 Etiology and pathogenesis of emotional and emotional diseases

1.2.1 Etiology and pathogenesis of emotional and emotional diseases For the etiology of emotional and emotional diseases, the recognized theory is: sudden, strong or persistent emotional and emotional stimuli, exceeding the range of normal physiological activities of the human body itself, so that the human body's qi disorders, the internal organs of yin and yang, qi and blood disorders, thus resulting in the occurrence of the disease; Jin Guangliang[1] is of the opinion that, since the emotion is a manifestation of the function of the five viscera, it is dependent on the function of the five organs, which is the function of the five organs, which is the function of the organs. Activity of the performance of the five organs, its generation depends on the activities of the internal organs essence, external stimuli, etc., then, the etiology of the disease should not be the mood itself, but only the external adverse stimuli. Tang Xianyu [8] pointed out that the external stimuli and individual differences in constitution are two important aspects of the onset of the impact of love affair, qi elevation disorders, visceral dysfunction, the destruction of the balance of yin and yang, so that the positive qi is weak, the invasion of evil qi is the pathological mechanism of love affair disease. Jin Xi [9] and others believe that qi dysregulation is the key mechanism for the onset of love affair disease, because of the many reasons leading to qi dysregulation, so its pathology is intricate and complex, but the basic pathology of the law of qi dysfunction and real more than virtual less, visceral dysfunction meridian is not conducive to qi disease in the first involved in the blood and fluids of the three major features. Sun Lijun [10] pointed out that there exists in the human body to undertake the overall regulation system of emotional activities for the Chinese and Western medicine **** knowledge, Chinese medicine of the emotional regulation system centered on the five viscera, essence, gas, blood, fluid as the material basis, so the intermediary mechanism of emotional illness for the visceral qi and blood, in particular the five visceral dysfunction of the qi; modern medicine of the emotional regulation system is the neuroendocrine immune system network, the material basis of neurotransmitter, hormones and Immunoactive substances, emotional illness through the stimulation of closely related to the internal organs of the neuroendocrine system, which in turn reduces the body's immune ability, therefore, the theory of emotional illness in Chinese medicine has its important immunological basis.

1.2.2 Characteristics of emotional pathogenesis Emotional pathogenesis directly injures the internal organs, so that qi reversal, qi and blood imbalance has been scholars **** knowledge, but the characteristics of emotional pathogenesis and injury to the viscera bias have their own opinions, that emotional pathogenesis is prone to injure the liver is more. Lu Mingyuan [11] believes that, emotional illness can be urgent or slow, mostly two or more emotional complex damage to the human body, the onset of a variety of emotional illnesses with *** the same intermediary pathology; emotional lesions can be presented in the qi disorders, fire injury to the yin, shape and quality of the loss of phlegm and blood depletion and other different pathological stages, the onset of the beginning of the disease, i.e., the qi disorders and loss of ambition, the gods and the loss of consciousness, so that the five visceral dysfunction, the further development of the lesions, the cause of phlegm and fire, Further development of the pathology leads to secondary pathologies such as phlegm-fire, blood stasis, and loss of qi, blood, fluid, and essence. Xu Zhiwei [7] found that the spleen and stomach, liver and gallbladder, heart and brain play the closest roles in the pathogenesis of emotion and mood through a large sample of people. Cheng Kanglin [12] and others believe that the seven emotional excesses can affect both qi and damage to the five organs, qi movement is blood flow, qi stagnation is blood stasis, blocked in the heart of the veins and channels, can lead to the occurrence of cardiovascular disease. Qiao Mingqi et al [13] by the emotional illness medical case statistical analysis and emotional illness epidemiological research that, "five will injure the five organs" model does not meet the clinical reality, a variety of emotional intertwining *** with the probability of disease and illness injury to the liver is greater, the "social event" is the formation of emotional stimuli to start. Social events" are the starting factors for the formation of emotional stimuli. Therefore, the hypothesis of "multiple emotions intertwine*** with the disease first liver injury" was proposed and logically demonstrated. Li Feng et al [14] believe that the core of the body's regulation of stress response is the liver, emphasizing that the liver plays a decisive role in regulating the various changes caused by emotional factors (psychological stress). Guo Lei [15] believed that emotional activities are closely related to the liver, and that the liver's main function of detoxification is particularly relevant to gynecological disorders, and that the liver should be the first to be regulated in the treatment of these disorders. Tang Zhaohui et al [16] believe that, whether from the psychological or physiological point of view, Chinese medicine, "thoughts of injury" in the process of the seven feelings of disease are in a central position, playing a leading role in the study and treatment of diseases caused by emotions and feelings of the "thoughts of injury" should be given due attention. Bai Zhengyong et al [17] explored the relevance of the spleen in hiding emotions, pointing out that the spleen is the main center of qi, and the spleen of the middle earth plays a role in regulating and balancing the activities of emotions and feelings. Zhang Zongfang [18], on the other hand, pointed out that kidney deficiency is the root cause of mental and emotional abnormalities during menopause.

1.2.3 Emotional and emotional diagnosis Xu Zhiwei [7] believes that "emotional and emotional diagnosis" consists of four elements: etiological elements - for the "joy, anger, worry, thoughts, fear, sadness, shock" of the seven emotions of the movement; the elements of the location of the disease -Seven emotions correspond to the five viscera, the main idea of "emotional diagnosis" is to take the five viscera as the center, to the body as a symptom of emotional changes, the human body's emotional activities and the relationship between the internal organs associated with the process of dialectical thinking; characteristics of the disease - "seven emotions". "Disease-causing mostly due to the spirit of emotional internal injuries and the main cause of body qi elevation disorders, visceral dysfunction, qi, blood, yin and yang balance imbalance of the pathogenesis of the changes," "emotional diagnosis," the characteristics of the pathology should be combined with the eight platforms of the identification, qi, blood, fluid identification, visceral diagnosis, Wei qi, blood diagnosis, triple jiao diagnosis, etc. to explore. Therefore, the main content of "emotional identification" is closely related to spiritual and emotional activities, and the main points of identification can be based on spiritual symptoms, and cannot be blamed on a single internal organ for an independent emotional change. The law of transmission - although the emotional and emotional problems hurt the five viscera and six bowels, but the first disease in the liver, spread the disease in the heart, and gradually and other organs.

2 experimental research

In recent years, based on the theory of Chinese medicine and the seven emotional theory, combined with modern psychological theory, the Chinese medical profession carried out experimental research on the pathogenesis of emotional and Chinese medicine prevention and treatment: Qiao Mingqi et al. [13] through many years of work in the liver and emotional exploration of the pathogenesis of the liver and the liver Tibetan phenomenon, perfected the "liver qi inverse, liver gas depression" two concepts, the establishment of the liver and the liver, and the liver, the liver and the liver. Through years of exploration on the mechanism of liver zangxiang and emotional and moral pathogenesis, Qiao Mingqi et al [13] perfected the concept of "liver qi reversal and liver qi depression", established the identification criteria and rat model, and created the first macaque model of liver qi reversal and liver qi depression in premenstrual syndrome (PMS), which has been used as a guide for the development of the first new drugs for the treatment of PMS in China, namely "Premenstrual Pinking Granules" and "Premenstrual Shu Granules "Yan Chan et al. [19-20] started from the liver and used the constraint braking model to explore the pathogenesis of the psychological stress NEI network and the interventional effect of the liver-regulating formula, suggesting that the liver-regulating formula showed multi-level, multi-target, multi-link regulation of central neuroinformatic factors; Ma Yuan et al. 21] observed the effect of six flavors of dihuang soup on the changes of hypothalamic-pituitary-ovarian axis function in suspension stress mice, and found that oral administration of six flavors of dihuang soup could significantly increase the levels of hypothalamic GnRH and pituitary LH and decrease the concentration of serum estradiol in the mice; Han Juan [22] simulated the evidence of qi disorders in rats caused by affective and emotional stimuli by rotating, restraining and crowding, and administered the formula Shu Xin No. 1 to the rats to make them feel better. Shu Xin 1 could increase the content of NE, 5-HT and Ach in the hypothalamus of stress rats; Liang Shanghua et al [23] used an electrical stimulation model study to suggest that the herbal compound with the effects of strengthening the spleen and benefiting the qi, resolving phlegm and warming the yang could adjust the abnormality of the HPA axis in chronic stress rats to varying degrees. Li J et al. [24] simulated the etiology of "seven emotional disorders" by immersing rats in water, and demonstrated that the disturbance of qi caused by adverse stimuli was related to the disturbance of HPA regulation. In view of the wide application of Wen Gao Tang in the treatment of mental, physical and mental disorders, He Yishun et al.[25] suggested that Ning Shen Wen Gao Tang (Wen Gao Tang Plus Flavor) may play a role in the treatment of psychoneurological disorders by changing the content of monoamines and amino acid neurotransmitters in brain tissue. Wang Miqiu et al [26] have pushed the study of "fear of kidney injury" stress to the forefront of emotional psychology, psychosomatic medicine, genetic psychology and Chinese medicine psychology through the accumulation of research on the overall behavior, physiopathology, immunity, biochemistry, molecular biology and other aspects of fear.

3 Existing problems and thinking

In summary, in recent years, the Chinese medical profession has carried out a number of research work on emotional diseases, and has made certain achievements: theoretical research, new hypotheses on the original basic theory of the question and challenge; experimental research, a single emotional stimulation of injury to the organs is mainly concentrated in the "anger injury to the liver", "fear of injury to the kidneys", "fear of injury to the kidneys", "fear of injury to the kidneys", "fear of injury to the kidneys", and so on. In the experimental research, single emotional stimulation injures the organs mainly focusing on "anger injures the liver" and "fear injures the kidney", but the research work has been deepened to the role of the liver as the main regulator of neurological, endocrine and immune networks, and the emotional genetics of fear, etc.; the successful establishment of the rhesus macaque monkey model of PMS with the evidence of hepatic qi reversal and hepatic qi depression, which is a disease that firstly injures the liver; the successful establishment of the new drug market, which provides a good basis for further research. new drugs on the market, has laid a good foundation for further research. However, analyzing the overall research status, there are still problems worth thinking about.

As far as theoretical research is concerned, there is still no uniform understanding of the concept of affectivity and the connotation of affective disease evidence, which is the first issue that must be clarified in the study of affective disease; otherwise, the systematic research work on the identification of affective disease and its standardization and quantification can not be carried out in a scientific and orderly manner. From the experimental research, there are three deficiencies: First, the acute and chronic stress model used in the current research on affective pathogenesis is mostly a single stressor stimulation model, and there is a certain gap with the reality of human composite multifactorial stress response to disease; second, some studies on exploring rationality with medicines are inconsistent in the choice of model, and even if they belong to the same kind of research on similar effects of prescription medicines, it is difficult to compare them, which is not conducive to their scientific evaluation and Thirdly, there is a close correlation between the pathogenicity of emotions and moods and the time, nature, intensity and individual differences of multifactorial stimuli, but there are few quantitative studies on the pathogenic conditions of emotions and moods at present. In addition, is it scientific to study the pathogenesis of emotion and mood with the theory that a single emotion and mood injures specific internal organs inherent in Chinese medicine? Does a single emotional stimulus hurt other organs at the same time? At present, there is no experimental evidence; in a single or composite stressor stimulation of the physiology of the Tibetan elephant is not clear, the study of Chinese medicine deep mechanism, there is inevitably blindness, systemic and holistic regulatory mechanism is difficult to elucidate; Chinese medicine related research is focused on the liver, involving the other internal organs of the research is obviously insufficient, etc. is also a problem worthy of consideration.

Based on the above problems, we believe that the following work needs to be explored: in the theoretical research, it is imperative that the Chinese medicine community needs to be based on the ancient and modern relevant research literature, and by expert seminars to clearly define the concept of emotion, the connotation of emotional illness; on the existing doubts about the original theory, after scientific evidence to be discarded, to put forward innovative scientific hypotheses, and in the clinical and experimental research to be tested, sublimation, established. In terms of experimental research, animal models are used. In terms of experimental research, the animal model, the existing recognized single stressor model, chronic compound stress model for comparative research, screening out the simulation of human emotions and feelings of disease (single emotion, multi-emotional intertwined) the most ideal model, but also the combination of disease and evidence to prepare a model, and the establishment of a quantitative evaluation criteria, through the macro-micro combination of the overall study, respectively, to explore the model of the physiological and pathological characteristics of the injured organs and the law In order to realize the breakthrough and innovation of the scientific research on the theory of emotional and emotional pathogenesis, we should integrate the multidisciplinary methods of Chinese medicine, modern medicine and psychology on the basis of the model research to explore the overall, organizational, cellular and molecular levels and links from the aspects of behavioral characteristics, structure, function and metabolism; the research on effective prescription drugs should focus on the pharmacological and physiological features and laws of each model. The research of effective prescription drugs should emphasize on the efficacy of the drugs, and after the screening research, then carry out the mechanistic exploration and new drug development research. In short, in order to make the research on the prevention and treatment of emotional diseases in Chinese medicine really into a scientific track, and ultimately form a set of diagnosis, treatment, prevention in one of the emotional medical system, there are still a lot of difficult work to look forward to the synthesis of multidisciplinary knowledge and technology, organized and planned to complete one by one.