Research On Pathogenic Manners And Rules Of Emotion

Objective :It has been recognized that epigastralgiais caused by the liver injuried by emotions,the liver failing to maintain the normal flow of qi,stomach-qi being anable to descend normally.But pathogenic manners which are closely related to epigastralgia, and the pathogenic manners'origin, and their internal psychological mechanism are still unclear. The liver failing to maintain the normal flow of qi is divided into hyperactivity of liver-qi and deficency of liver-qi. The relevance of hyperactivity of liver-qi and deficency of liver-qi with specific syndrome of epigastralgia has not been systematically studied yet. Based on self-questionnaire of emotional etiology and Speilberger's state-trait anger expression inventory 2 (STAXI-2)which was translated and revised preliminary, the emotional etiology, pathogenesis ,state-trait and expression of epigastralgia were systematically studied here in order to effectively prevent and treatepigastralgia.Methods: Using questionnaire of emotional etiology and STAXI-2,107 cases of epigastralgiainduced by emotional factors were investigate in the Division of Gastroenterology, Internal Medicine Department of Shandong Province Hospital of Traditional Chinese Medicine, by cross-sectional epidemiological investigation methods. The main investigation included: the general situations, the cause of emotion, complicated causes, social events, the main symptoms, TCM diagnosis, viscera injury, Western diagnosis, ect. The data were analyzed by frequency analysis, factor analysis and cluster analysis. In order to make it clear of the relationship of emotional state expression and epigastralgia, 107 cases of normal people were selected to fill in STAXI-2, and their state-anger, trait-anger, anger expression (anger-in/out; anger-expression/contrul) were compared with 107 epigastralgia patients. The data from these two groups were analyzed by variance analysis. At the same time, the type differences were also compared.Result : People in the classes of high level of education, mental work, middle-aged and elderly old, women were more attacked by emotional factors and led to epigastralgia than other classes. Estranged family relationships and estranged interpersonal relationships were the main origin factors ofepigastralgia. The related negative emotions, such as anger, too much thinking, worry, were main emotional causes of epigastralgia. epigastralgia could be induced by either single or intertwined emotional disorder. Factor analysis showed that the most frequent combinations of the emotional disorder include thought with fear, depression with sadness , anger-out and anger-in. Emotional disorder could induce disease by its own or combine with other factors, such as eating disorder, excess work, et al. Emotional disorders could cause both functional gastrointestinal disease and organic gastrointestinal diseases. The main symptoms were stomach pain, abdominal distention,eructation,acid regurgitation,loss of appetite and pyrosis. Other accompanied symptoms includes side chest pain, headache where the liver meridian runs by. When the main symptoms were analyzed by variable clustering and sample clustering, two categories of clustering results were revealed. Based on basic theory of traditional Chinese medicine, the symptoms were divided into liver-qi invasion and liver-qi depression, and the mostly involved organ injury is liver followed by stomach.There were significant differences of angry trait and anger expression between epigastralgia patients and normal persons(P <0.01). Differences were also found in state-anger, trait-anger, anger expression in different types.Conclsion: (1) Estranged family relationships and estranged interpersonal relationships were the main origin factors ofepigastralgia.(2) The main negative emotions related to epigastralgiawere anger, stress thinking, and worry. Both single emotion disorder and intertwined emotions could cause epigastralgia. Emotional disorder could induce disease by its own or combine with other factors, such as eating disorder, excess work, et al.(3)The liver injured by emotion ,the liver failing to maintain the normal flow of qi ,hyperactivity of liver-qi could lead to liver-qi invasion syndrome, expressed on pigastralgia was hyperactive liver-qi attacking the stomach.Deficency of liver-qi could cause liver-qi depression syndrome,expressed on epigastralgia was stagnation of liver-qi and stomach-qi. There were two different pathogenesis of epigastralgia caused by emotions, which were hyperactice liver-qi attacking the stomach and stagnation of liver-qi and stomach-qi.It pointed out that treatingepigastralgiafrom liver could be regarded as the principle of epigastralgia due to the liver injuried by emotions, and method of astring liver-qi and method of dispersing the stagnated liver-qi should be used to treat different type of the disease.(4) Trait angry an inappropriate expression of angry were the psychological mechanisms ofepigastralgia.The results laid the foundation for psychological intervention to epigastralgia.