惊恐障碍中医精神与躯体症状网络分析

doi:10.3969/j.issn.1006-7795.2026.03.019

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (3): 558-568.doi: 10.3969/j.issn.1006-7795.2026.03.019

• 精神科中西医结合临床及认知神经基础 • 上一篇下一篇

惊恐障碍中医精神与躯体症状网络分析

赵爽^1,2,徐天朝^3*#,宋明康^1,2*#,贾竑晓^1,2,李冬冬³,尹冬青^1,2,李雪^1,2

1.首都医科大学附属北京安定医院国家精神疾病医学中心精神心理疾病国家临床医学研究中心精神疾病创新药智能研发北京市重点实验室，北京 100088；2.人脑保护高精尖创新中心，首都医科大学，北京 100069；3.中国人民解放军北部战区总医院精神心理科，沈阳 110021

收稿日期:2026-02-06 修回日期:2026-03-09 出版日期:2026-06-21 发布日期:2026-06-26
通讯作者: 徐天朝, 宋明康 E-mail:xtc_bucmp@126.com， songmed.001@gmail.com
基金资助:
北京中医药薪火传承“新3+3”工程示范案例项目（2023-ZYSF-19），辽宁省自然科学基金（20170540961）。

A network analysis of the Traditional Chinese Medicine psychic and somatic symptoms in panic disorder

Zhao Shuang^1,2, Xu Tianchao^3*#, Song Mingkang^1,2*#, Jia Hongxiao^1,2, Li Dongdong³, Yin Dongqing^1,2, Li Xue^1,2

1.Beijing Anding Hospital, Capital Medical University；National Center for Mental Disorders；National Clinical Research Center for Mental Disorders；Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders， Beijing 100088, China; 2. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China; 3. Department of Psychiatry, General Hospital of the Northern Theater of the Chinese People's Liberation Army, Shenyang 110021, China

Received:2026-02-06 Revised:2026-03-09 Online:2026-06-21 Published:2026-06-26
Supported by:
This study was supported by Beijing Traditional Chinese Medicine Inheritance “New 3+3” Program Demonstration Case Project（2023-ZYSF-19），Liaoning Provincial Natural Science Foundation (20170540961).

摘要/Abstract

摘要： 目的探索惊恐障碍（panic disorder, PD）中医症状关系及核心精神与躯体症状。方法研究采用网络分析方法，构建基于183例PD患者的中医精神症状网络、躯体症状网络、躯体症状与核心精神症状网络、核心精神与核心躯体症状网络，并计算中心性指标。结果在中医精神症状网络中，入睡困难的中介中心性较高；入睡困难、善恐易惊的接近中心性较高；紧张不安、无故担忧的预期影响较高。在中医躯体症状网络中，心悸、胸闷的中介中心性较高；心悸、胸闷、舌苔黄的接近中心性较高；心悸、胃脘胀闷的预期影响较高。对于躯体症状与核心精神症状网络，精神症状中紧张不安的预期影响较高。心悸在核心精神与核心躯体症状中有着最高的中心性水平。结论 PD的核心中医精神症状包括入睡困难、紧张不安、无故担忧、善恐易惊；核心中医躯体症状包括心悸、胸闷、胃脘胀闷、舌苔黄。心悸是其中最为核心的症状。网络结构与核心症状主要反映了肾、心、脾三者的脏腑病机变化，同时提示了依据精神症状对PD进行辨治的必要性，为PD的中医临床诊疗提供了可行思路和方向。

关键词: 惊恐障碍, 中医, 精神症状, 躯体症状, 网络分析, 核心症状

Abstract: Objective To explore the associations between Traditional Chinese Medicine (TCM) symptoms in patients diagnosed with panic disorder (PD) and identify the core TCM psychic and somatic symptoms. Methods A TCM psychic symptom network, a somatic symptom network, a somatic symptom and core psychic symptom network, a core psychic and core somatic symptom network were constructed by using network analysis based on the TCM psychic and somatic symptoms in 183 PD patients. Centralization indices were calculated. Results In the TCM psychic symptom network, the betweenness was higher for difficulty initiating sleep; the closeness was higher for difficulty initiating sleep, being easily to be frightened and alarmed; the expected influence was higher for nervous and restless, excessive worry inclued. In the TCM somatic symptom network, the betweenness centrality was higher for palpitations, chest tightness; and the closeness centrality was higher for palpitations, chest tightness, yellow tongue coating; expected influence was higher for palpitations, and gastric distension. For the network of somatic symptoms and core psychic symptoms, nervousness and restlessness exhibited high expected influence among psychic symptoms. Palpitations emerged as the most central symptom in the core psychic and core somatic symptom network. Conclusion The core TCM psychic symptoms of PD difficulty initiating sleep, nervous ness and restless ness, excessive worry , and being easily to be frightened and alarmed, while the core TCM somatic symptoms are palpitation, chest tightness, abdominal distension and stomach is swollen, yellow tongue coating. The network structure and core symptoms mainly reflect the pathological connections of the kidney, heart and spleen. The study emphasizes the necessity of syndrome differentiation and treatment for PD based on psychic symptoms and provides feasible strategies for the clinical diagnosis and therapeutic interventions of PD in TCM.

Key words: panic disorder, Traditional Chinese Medicine, psychic symptom, somatic symptom, network analysis, core symptoms

中图分类号:

赵爽, 徐天朝, 宋明康, 贾竑晓, 李冬冬, 尹冬青, 李雪. 惊恐障碍中医精神与躯体症状网络分析[J]. 首都医科大学学报, 2026, 47(3): 558-568.

Zhao Shuang, Xu Tianchao, Song Mingkang, Jia Hongxiao, Li Dongdong, Yin Dongqing, Li Xue . A network analysis of the Traditional Chinese Medicine psychic and somatic symptoms in panic disorder[J]. Journal of Capital Medical University, 2026, 47(3): 558-568.

参考文献

［1］DeGeorge K C, Grover M, Streeter G S. Generalized anxiety disorder and panic disorder in adults［J］. Am Fam Physician, 2022, 106(2): 157-164.
［2］De Jonge P, Roest A M, Lim C C W, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys［J］. Depress Anxiety, 2016, 33(12): 1155-1177.
［3］Aljadani A, Alshammari K, Alshammari M, et al. Prevalence and predictive factors of panic disorder among adults in Saudi Arabia: a cross-sectional study［J］. J Epidemiol Glob Health, 2024, 14(3): 730-739.
［4］Pizzolla E, Tecco J M, Petzold M B, et al. A network analysis of panic disorder, agoraphobia, and generalized anxiety disorder in 463 patients from a psychiatric hospital［J］. Brain Behav, 2026, 16(2): e71241.
［5］Zhang Y, Wang J J, Xiong X, et al. Suicidality in patients with primary diagnosis of panic disorder: a single-rate meta-analysis and systematic review［J］. J Affect Disord, 2022, 300: 27-33.
［6］Özdemiri, Kuru E. Investigation of cognitive distortions in panic disorder, generalized anxiety disorder and social anxiety disorder［J］. J Clin Med, 2023, 12(19): 6351.
［7］贾竑晓. 精神症状五神藏辨治体系的构建［J］. 北京中医药大学学报, 2024, 47(12): 1629-1636.
［8］尹冬青, 贾竑晓. 贾竑晓基于中医“五神藏”以精神症状为主辨治精神类疾病的学术思想探讨［J］. 中华中医药杂志, 2017, 32(6): 2544-2547.
［9］Wittchen H U, Essau C A. Epidemiology of panic disorder: progress and unresolved issues［J］. J Psychiatr Res, 1993, 27(Suppl 1): 47-68.
［10］Kirmayer L J. Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment［J］. J Clin Psychiatry, 2001, 62(Suppl 13): 22-30.
［11］季建林. 住院病人的焦虑障碍［J］. 中国临床医学杂志, 1998(2): 101-103.
［12］何筱衍, 李春波. 焦虑障碍躯体症状的临床研究进展［J］. 中国全科医学, 2008, 11(9): 774-776.
［13］贾竑晓, 康玉春, 尹冬青. 王彦恒益肾平虑法治疗焦虑症的临床经验探讨［J］. 中华中医药杂志, 2014, 29(7): 2243-2246.
［14］贾竑晓, 尹冬青. 中医“五神藏”理论与常见精神症状的中医病位［J］. 现代中医临床, 2020, 27(5): 68-72.
［15］Tunnell N C, Corner S E, Roque A D, et al. Biobehavioral approach to distinguishing panic symptoms from medical illness［J］. Front Psychiatry, 2024, 15: 1296569.
［16］Zainal N H, Van Doren N. Sleep disturbances predict nine-year panic disorder chronicity: the sleep-panic nexus theory with machine learning insights［J］. J Anxiety Disord, 2025, 114: 103052.
［17］Gros D F, Pavlacic J M, Wray J M, et al. Investigating relations between the symptoms of panic, agoraphobia, and suicidal ideation: the significance of comorbid depressive symptoms in veterans with panic disorder［J］. J Psychopathol Behav Assess, 2023, 45: 1154-1162.
［18］Cha E J, Hong S, Park D H, et al. A network analysis of panic symptoms in relation to depression and anxiety sensitivity in patients with panic disorder［Ｊ］. J Affect Disord, 2022, 308: 134-140.
［19］Lazarov A, Suarez-Jimenez B, Levi O, et al. Symptom structure of PTSD and co-morbid depressive symptoms: a network analysis of combat veteran patients［Ｊ］. Psychol Med, 2020, 50(13): 2154-2170.
［20］Borsboom D. A network theory of mental disorders［Ｊ］. World Psychiatry, 2017, 16(1): 5-13.
［21］蔡玉清, 董书阳, 袁帅, 等. 变量间的网络分析模型及其应用［Ｊ］. 心理科学进展, 2020, 28(1): 178-195.
［22］Papachristou N, Barnaghi P, Cooper B, et al. Network analysis of the multidimensional symptom experience of oncology［Ｊ］. Sci Rep, 2019, 9(1): 2258.
［23］Lu J, Zhang Q, Zhong N, et al. Addiction symptom network of young internet users: Network analysis［Ｊ］. J Med Int Res, 2022, 24(11): e38984.
［24］Organization W H. The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines［Ｍ］. Geneva: World Health Organization, 1992.
［25］朱文锋, 袁肇凯. 中医诊断学［Ｍ］. 北京: 人民卫生出版社, 2011.
［26］Maier W, Buller R, Philipp M, et al. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders［Ｊ］. J Affect Disord, 1988, 14(1): 61-68.
［27］Yang J, Xu N, Liang M. A longitudinal study on the correlation between symptom clusters and disease-specific health status in older adults with chronic obstructive pulmonary disease during pulmonary rehabilitation［Ｊ］. Front Public Health, 2026, 14: 1720782.
［28］Liu Y, Li S, Li Y, et al. Exploring core and bridge symptoms among people with type 2 diabetes mellitus in China: A network analysis［Ｊ］. J Clin Nurs, 2026, 35(3): 1270-1281.
［29］冯正田, 郑思思, 李雪, 等. 基于层次聚类与复杂症状网络的广泛性焦虑障碍之上热下寒证的症状关系［Ｊ］. 首都医科大学学报, 2022, 43(3): 398-406.
［30］李雪, 冯正田, 郑思思, 等. 广泛性焦虑障碍中医精神症状与躯体症状网络分析研究［Ｊ］. 首都医科大学学报, 2023, 44(4): 568-577.
［31］Borsboom D, Deserno M K, Rhemtulla M, et al. Network analysis of multivariate data in psychological science［Ｊ］. Nat Rev Methods Primers, 2021, 1(1): 58.［32］Lepola U, Koponen H, Leinonen E. Sleep in panic disorders［J］. J Psychosom Res, 1994, 38(Suppl 1): 105-111.
［33］Cervena K, Matousek M, Prasko J, et al. Sleep disturbances in patients treated for panic disorder［J］. Sleep Med, 2005, 6(2): 149-153.
［34］Seguí J, Salvador-Carulla L, García L, et al. Semiology and subtyping of panic disorders［J］. Acta Psychiatr Scand, 1998, 97(4): 272-277.
［35］Jeejeebhoy F M, Dorian P, Newman D M. Panic disorder and the heart: a cardiology perspective［J］. J Psychosom Res, 2000, 48(4/5): 393-403.
［36］Zinbarg R E, Williams A L, Mineka S. A current learning theory approach to the etiology and course of anxiety and related disorders［J］. Annu Rev Clin Psychol, 2022, 18: 233-258.
［37］Roy-Byrne P P, Craske M G, Stein M B. Panic disorder［J］. Lancet, 2006, 368(9540): 1023-1032.
［38］Mellman T A, Uhde T W. Sleep panic attacks: new clinical findings and theoretical implications［J］. Am J Psychiatry, 1989, 146(9): 1204-1207.
［39］Roy-Byrne P P, Uhde T W, Post R M. Effects of one night's sleep deprivation on mood and behavior in panic disorder. Patients with panic disorder compared with depressed patients and normal controls［J］. Arch Gen Psychiatry, 1986, 43(9): 895-899.
［40］李自艳, 宁艳哲, 王丹. 贾竑晓以五神藏理论结合睡眠异常模式辨治失眠经验［J］. 中医杂志, 2023, 64(3): 236-239.
［41］Wang Y F, Chen X F, Wei W, et al. Efficacy and safety of the Chinese herbal medicine Xiao Yao San for treating anxiety: a systematic review with meta-analysis and trial sequential analysis［J］. Front Pharmacol, 2023, 14: 1169292.

惊恐障碍中医精神与躯体症状网络分析

A network analysis of the Traditional Chinese Medicine psychic and somatic symptoms in panic disorder

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价