創傷後壓力症候群的情節記憶缺損與中醫治療

Episodic Memory Deficits and Traditional Chinese Medicine Therapy in Post-Traumatic Stress Disorder

蕭坤元(Kun-Yuan Hsiao) ； 李季湜(Jay-Shake Li) ； 葉家舟(Chia-Chou Yeh)

《應用心理研究》 69期 (2018/12) Pp. 157-205

https://doi.org/10.3966/156092512018120069006

摘要

創傷後壓力症候群（Post-traumatic stress disease, PTSD）是一種由重大情緒事件引發，所產生的一連串生理與心理過度反應。其中在患者的認知缺損方面，情節記憶功能降低是相當受到關注的一項症狀。由於眾多研究證實，前額葉皮質對於情節記憶處理相當重要，而臨床上亦發現PTSD患者前額葉神經活性減少。此外，在中醫上可用來治療PTSD的逍遙散，也經動物實驗顯示可以影響前額葉皮質區域中，多種神經生化系統。故我們合理地預期，在PTSD的病理機制當中，情節記憶與前額葉皮質應該佔有一席之地。然而，目前尚未有一神經機制理論，可以完整地描述情節記憶與PTSD的關係，以及解釋某些中醫藥物在其中扮演之角色。因此我們在本文中，回顧了關於PTSD以及情節記憶神經迴路的文獻，企圖提出以前額葉皮質為核心的PTSD病理機 制理論。我們認為，重大情緒刺激可能造成前額葉皮質的功能降低，因而使得患者的記憶功能失調。而逍遙散這類的中醫治療，就針對前額葉腦區產生效果。最後，提出了驗證性的實驗，以指引將來進一步研究的方向。

關鍵字

中藥治療 ； 前額葉 ； 情節記憶 ； 逍遙散 ； 創傷後壓力症候群

並列摘要

Post-traumatic stress disorder (PTSD) is a collective series of overreacting responses to an impactful emotional event. Among the diverse cognitive deficits of PTSD patients, severe episodic memory (EM) impairment has attracted a lot of attention. It is well known that the prefrontal cortex (PFC) plays an important role in both PTSD and EM. Furthermore, Xiaoyaosan, a formula used in Traditional Chinese Medicine (TCM) to relieve negative emotions, has been shown to affect the PFC neurotransmitter systems in animals. Thus, it seems reasonable to connect both PFC and EM to the pathological mechanisms of PTSD. However, no theory can yet fully describe the relationships among EM, PTSD, and TCM. In this article, we test and confirm two hypotheses: 1) a strong emotional stimulus weakens PFC functions, which leads to EM impairments; 2) Xiaoyaosan asserts it benefits by affecting PFC neurotransmitter systems.

並列關鍵字

episodic memory ； prefrontal cortex ； post-traumatic stress disorder (PTSD) ； Traditional Chinese Medicine (TCM) ； Xiaoyaosan

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