A case of comorbidity of major headache with general anxiety disorder treated by "jueyin syndrome"
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1.Sleep Psychology Clinic, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 101100, China
2.Department of Emergency, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 101100, China.
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LI Hongyan, Lin Wenhu. A case of comorbidity of major headache with general anxiety disorder treated by "jueyin syndrome"[DB/OL].(2023-08-11)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=40662170&Fpath=home&index=0
病史摘要,2,中老年男性患者,因“躯体不适、紧张不安反复发作2年”就诊。2年来头痛程度逐渐加重,频率逐渐增加,发作无明显规律性,位置不固定,偶有头晕,常有胃脘部隐痛、心前区不适、胸口发紧、背部疼痛,曾多次于我院及外院急诊或住院治疗,反复检查心电图、心肌酶等未见明显异常,曾行CTA检查未见明显异常。精神检查:意识清,接触可,问答切题,表情愁苦,语速快。近记忆力减退,主动就医,自知力存在。HAMA评分29分。刻下症见:患者表情愁苦,交谈中显坐立不安,觉浑身紧张,双上肢细颤。畏寒喜暖,胃脘不适,无口干口苦,纳可,夜眠差,近一周入睡困难,入睡时间1~2小时。二便可。中医诊断 头痛 (厥阴证);郁病 (厥阴证)西医诊断 头痛;广泛性焦虑干预措施 中医以寒热并用、温肾疏肝为治法;中药方剂以乌梅丸加减,配合认知行为治疗、放松训练、调畅情绪、避免劳累、适当锻炼等措施,先后于门诊治疗5次。疗效转归 患者服药后疗效显著,精神性焦虑发作频率明显减少,头痛发作频率及疼痛程度明显减轻,躯体性焦虑已无发作,自主神经功能基本恢复正常,HAMD减分率≥50%。
Summary of casehistory, A 56-year-old male patient presents comes to see doctor due to recurring somatic pain and nervousness for 2 years. In the past 2 years, the degree of headache has gradually worsened, the frequency has gradually increased, the attacks were not obviously regular, and the location was not fixed. The patient has dizzy occasionally, have dull pain in the stomach, precordial discomfort, chest tightness, back pain usually, which has been checked and treated in our hospital and other hospitals with repeated examination of electrocardiogram, myocardial enzymes, etc. and the results showed no obvious abnormalities, and CTA examination did not show obvious abnormalities. Mental symptom: Clear consciousness, contact is acceptable, questions and answers are relevant, He feels sad, and speech speed is fast. He always feel nervous and worried, be afraid of the impact of the epidemic. self-awareness exists. The HAMA score is 28. Symptoms at present: The patient's expression is sad, restless during the conversation. He feels nervous and his upper limbs is tremble. He likes warmth, aversion of cold. He feels stomach discomfort, with no thirsty or bitter feeling in mouth. He has normal appetite. He doesn't sleep well, it is difficult to fall asleep for almost a week, and it takes 1~2 hours to fall asleep. His defecation and urination are normal.,TCM diagnosis, Headache, jueyin syndrome. Depression, jueyin syndrome.,Western medicine diagnosis, Headache;General anxiety disorder(GAD).,Therapeutic methods, applied replenishing kidney and regulating liver, mixing cold and heat as the treatment in Traditional Chinese medicine. Herbal medicine with WuMei pills plus or minus, with cognitive behavioral therapy, relaxation training, emotional adjustment, avoidance of fatigue, appropriate exercise and other measures. This patient has been treated in outpatient clinics for 5 times.,Clinical outcomes, The patient had a significant effect after taking the drug, the frequency of mental anxiety attacks was significantly reduced, the physical anxiety was no longer attack-free, the HAMA score reduction rate≥50%.
头痛广泛性焦虑厥阴证类乌梅丸【适合阅读专业】 脑病科精神科
【Suitable majors】 EncephalopathyPsychiatry
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