焦虑障碍是常见精神疾病之一，临床表现为情绪异常和多系统躯体不适，其身心共病的特点契合中医“形神一体”理念。中医多将本病归属于郁病、脏躁、忧思病等神志疾患范畴进行论治。临床观察发现，肝气疏泄失常，脾胃运化失健是焦虑障碍的主要病机。本文以中医五行学说为基础，结合现代研究成果，从肝脾生理与病理关联为重点，探究焦虑障碍的发病机制与演变规律，将其分为木郁克土、木不疏土、土虚木乘三种证型，并系统阐述相应的治疗原则与方剂，以利于结合临床实际合理遣方用药。导师自拟方“焦虑平方”以肝脾同调为理念，能有效阻断肝气乘脾的病机传变，能使焦虑障碍患者的身心痛苦均得到显著改善，达到确切的治疗效果。

焦虑障碍是常见精神疾病之一，临床表现为情绪异常和多系统躯体不适，其身心共病的特点契合中医“形神一体”理念。中医多将本病归属于郁病、脏躁、忧思病等神志疾患范畴进行论治。临床观察发现，肝气疏泄失常，脾胃运化失健是焦虑障碍的主要病机。本文以中医五行学说为基础，结合现代研究成果，从肝脾生理与病理关联为重点，探究焦虑障碍的发病机制与演变规律，将其分为木郁克土、木不疏土、土虚木乘三种证型，并系统阐述相应的治疗原则与方剂，以利于结合临床实际合理遣方用药。导师自拟方“焦虑平方”以肝脾同调为理念，能有效阻断肝气乘脾的病机传变，能使焦虑障碍患者的身心痛苦均得到显著改善，达到确切的治疗效果。

【摘要】 目的 系统分析音乐干预对眼科手术患者围手术期焦虑与生理反应的影响，为其临床应用提供参考。方法 系统检索国内外相关文献，从患者焦虑特征、理论基础、实施方法、干预效果及影响因素等方面进行综合分析。结果 眼科手术患者围术期焦虑发生率较高，焦虑可降低术中配合度、增加麻醉用药等风险。音乐干预通过调节边缘系统及自主神经系统发挥作用，术前、术中持续应用可显著降低焦虑评分，稳定心率、降低血压。听觉敏感性、基线焦虑水平、年龄及干预方案特征是影响干预效果的关键因素。结论 音乐干预能有效缓解眼科手术患者围手术期焦虑，具有良好应用潜力。未来需开展大样本随机对照试验，结合人工智能等技术开发个性化方案，并建立标准化实施方法。

【Abstract】Objective To systematically evaluate the effects of music intervention on perioperative anxiety and physiological responses in ophthalmic surgery patients, and to provide evidence for clinical practice. Methods Domestic and international literature on anxiety characteristics, mechanisms, implementation, efficacy, and influencing factors was systematically searched and reviewed. Results Perioperative anxiety is common in ophthalmic surgery patients and may reduce intraoperative cooperation and increase anesthetic consumption. Music intervention acts on the limbic system and the autonomic nervous system, and can effectively reduce anxiety scores, stabilize heart rate, and lower blood pressure when applied preoperatively and intraoperatively. Key influencing factors include auditory sensitivity, baseline anxiety, age, and intervention features. Conclusions Music intervention safely and effectively relieves perioperative anxiety in ophthalmic surgery patients. Further large-sample randomized controlled trials, AI-based personalized programs, and standardized protocols are needed.

目的 分析音乐治疗焦虑领域研究热点的演变与趋势。方法 利用文献计量学方法对近20年（2003——2023）发表音乐治疗焦虑方面的研究与文献进行了可视化分析：对中国知网（CNKI）及Web of Science（WOS）文献库中收录的文献进行关键词（中文关键词：音乐治疗、焦虑;英文关键词：Music therapy、Anxiety）检索,利用CiteSpace 6.3 R2软件绘制知识图谱进行可视化分析。结果 通过文献的检索与筛选最终纳入中文文献506篇及英文文献1 782篇,其中国内外主要发文者为刘月芳、刘春艳、Bradt、Cold、Silverman等研究者团队,国内外主要研究机构均为高校,但国内高校相对于国外相关研究开展较为独立且合作联系较少;发文国家主要为美国、中国以及土耳其,西方国家之间的合作联系较为密切,我国开展相关跨地域研究主要是与亚洲国家进行多中心合作。国内研究热点为“音乐疗法”“心理干预”“五行音乐”等,国外研究热点为“Pain”“Depression”“Quality of life”等。结论 本文通过CiteSpace软件进行文献计量学分析发现,音乐治疗与焦虑结合是国内外研究的热点,国内研究聚焦于焦虑,而国外研究更关注音乐治疗在广泛心理问题中的应用。尽管该研究领域发展迅速,但国内外合作交流较少,国际研究团队间合作不够紧密。未来研究需进一步探索音乐治疗的机制和最佳实践方法,加强跨学科合作,利用科技创新,结合中国文化特色,以期实现音乐治疗在焦虑治疗中的更广泛应用,并提升患者的生活质量。同时,未来相关研究方法需多样化,以全面掌握研究趋势,为音乐治疗焦虑提供更有力的证据支持。

Objective To explore the evolution and trends of research hotspots in the field of music therapy for anxiety and provide reference and basis for related research．Methods Bibliometric analysis method was used to visualize and analyze the research and literature on music therapy for anxiety in the past 20 years（2003-2023）．Keyword searches were conducted in Chinese National Knowledge Infrastructure（CNKI）and Web of Science（WOS）databases,and a knowledge map was drawn using CiteSpace 6.3 R2 software for visualization analysis．Results Through the literature search and screening,506 Chinese and 1782 English literatures were included,and the main authors at home and abroad were researcher teams such as Liu Yuefang,Liu Chunyan,Bradt,Cold and Silverman．The main research institutions at home and abroad were universities,but domestic universities were more independent and had fewer collaborative relationships than foreign ones．The main publishing countries were the United States,China and Turkey,and there was closer cooperation between western countries．Multicenter cooperation with Asian countries was the main form of cross-region research in China．The research hotspots at home were “music therapy”,“psychological intervention”,“five elements music”,while the foreign research hotspots were “pain”,“depression”,and “quality of life”．Conclusions The combination of “music therapy” and “anxiety” is the main research hotspot at home and abroad in recent years．Among them,foreign scholars mainly use anxiety and other psychological problems as research topics to explore the application of music therapy to these issues,while domestic scholars focus on the research of anxiety and propose many music therapy programs for anxiety．In addition,there is relatively little cooperation and communication between domestic and foreign research sectors,and the degree of coincidence among international research teams is not high．Therefore,research teams at home and abroad should strengthen cooperation and communication．Based on the analysis of research hotspots in music therapy for anxiety in the past 20 years,this field has received considerable attention and has developed rapidly,but there are still many aspects that need to be explored and improved through continuous efforts and innovation．

目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P＜0.05),抑郁评分与全国常模相比则无统计学差异(P＞0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。

Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P＜0.05), while there was no statistical difference in depression scores between these two groups (P＞0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.

目的 探讨焦虑障碍与冠心病经皮冠状动脉介入治疗(PCI)患者术后发生对比剂肾病(CIN)的相关性及机制,为早期发现CIN高危人群及其预防提供理论依据。方法 入选2014年6月—2016年12月于天津市第四中心医院心内科住院确诊冠心病并接受PCI患者,进行综合医院焦虑/抑郁情绪测定表(HAD)及汉密尔顿焦虑量表(HAMA)评价,依据量表的评分标准,最终纳入研究共120例,其中焦虑障碍组60例,非焦虑障碍组60例。观察2组患者PCI术前及术后72 h肌酐(SCr)、肌酐清除率(Ccr)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、C反应蛋白(CRP)、白细胞介素-18(IL-18)的变化情况,并记录CIN的发生率。结果 2组患者PCI术前Scr、Ccr水平差异无统计学意义(P>0.05);2组患者PCI术后Scr水平均较术前升高,Ccr水平较术前降低(P<0.01)。PCI术后,焦虑障碍组Scr水平高于非焦虑障碍组,Ccr水平低于非焦虑障碍组(P<0.05)。2组患者PCI术前sICAM-1、CRP、IL-18、TNF-α差异无统计学意义(P>0.05);2组患者PCI术后sICAM-1、CRP、IL-18、TNF-α水平较术前均升高(P<0.01);PCI术后焦虑障碍组sICAM-1、CRP、IL-18、TNF-α水平高于非焦虑障碍组,差异有统计学意义(P<0.05)。PCI术前,焦虑障碍组HAD、HAMA评分高于非焦虑障碍组,差异有统计学意义(P<0.01);非焦虑障碍组患者PCI术后较术前HAD、HAMA评分差异无统计学意义(P>0.05);焦虑障碍组PCI术后HAD、HAMA评分高于术前,差异有统计学意义(P<0.01);PCI术后,焦虑障碍组HAD、HAMA评分高于非焦虑障碍组,差异有统计学意义(P<0.01)。结论 焦虑障碍可能是冠心病患者PCI术后发生对比剂肾病的危险因素之一。

目的 了解广州综合医院内分泌科门诊就诊者中抑郁焦虑障碍的患病率。方法 对广州市第一人民医院的内分泌科门诊就诊的患者进行横断面调查。采用医院焦虑抑郁量表(HADS)对105名入选的患者进行筛查,精神科医生对HADS≥8 分的患者进行国际神经精神科简式访谈问卷( MINI ) 的诊断性评估。结果 MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的患病率分别为3.80%、0.95%和2.86%。结论 抑郁和焦虑障碍是综合医院内分泌科门诊就诊者中的常见问题,但识别率和治疗率均不高。

Objective To investigate the prevalence rates of depressive and anxiety disorders of the endocrinology outpatients in a general hospital of Guangzhou. Methods A cross-sectional survey was conducted in the endocrinology outpatient department of Guangzhou First People's Hospital. A total of 105 outpatients were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini-international neuropsychiatric interview(MINI). Results The prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, and depressive-anxiety co-morbid disorders were 3.80%, 0.95% and 2.86%, respectively. Conclusion Depression and anxiety disorders are common problems in the endocrinology outpatient department of general hospitals,but few outpatients were well-diagnosed and treated.

目的 探讨脉管炎围手术期出现焦虑症状及影响因素和护理以提高在围手术期的生活质量。方法 通过对脉管炎患者进行问卷调查焦虑发生及影响因素。结果 脉管炎围手术期患者出现焦虑是十分常见的,生活质量下降直接或间接影响手术的成功率。结论 有效的护理干预能改善各方面的焦虑因素,使患者在围手术期保持心情舒畅,从而适应截肢形象的改变,提高生活质量。

目的 对兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗焦虑糜烂性胃炎患者的治疗效果进行研究。方法 选取2013年1月—2015年1月在我院收治的伴有焦虑情绪的糜烂性胃炎患者106例。随机分为对照组,给予兰索拉唑肠溶片治疗,观察组,给予兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗,并且对疗效进行比较。结果 治疗前,两组患者在腹痛、腹胀、反酸、嗳气以及黏膜糜烂各指标评分比较,差异无统计学意义(P>0.05);治疗后,2组患者以上指标均有所改善,并且观察组患者同期指标改善均优于对照组(P<0.05);治疗前,两组患者胃黏膜中PGE2和MDA含量无差异(P>0.05);治疗后,两组患者的PGE2均上升,而MDA则下降,并且观察组患者PGE2含量比对照组高,MDA则比对照组低,差异均有统计学意义(P<0.05);治疗前,两组患者HAMA、HAMD评分差异不明显,无统计学意义(P>0.05);治疗后,两组患者焦虑情况均有所改善,并且观察组患者情绪改善程度优于对照组患者,差异均有统计学意义(P<0.05);观察组不良反应发生率为5.6%,对照组不良反应发生率5.6%,差异无统计学意义,P>0.05。结论 兰索拉唑与氟哌噻吨美利曲辛联合应用有助于改善糜烂性胃炎患者的病情,并且可以缓解患者的焦虑情绪,安全性高,值得临床推广。

Objective To observe the clinical efficacy of lansoprazole enteric-coated tablets combined with flupentixol-melitracen in treating anxiety patients with erosive gastritis. Methods 106 patients with erosive gastritis and anxiety in our hospital from January 2013 to January 2015 were divided into an observation group and a control group, with 53 patients in each group. The control group was given lansoprazole enteric-coated tablets alone, and the observation group was treated with lansoprazole enteric-coated tablets and flupentixol-melitracen. Clinical symptoms and mucosal erosion were compared between the two groups of patients before and after treatment. Gastric mucosa malondialdehyde (MDA) and prostration E2 (PGE2) contents, anxiety and depression status were also assessed. Results After treatment, the scores of abdominal pain, bloating, acid reflux, belching, and mucosal erosions were significantly lower in the observation group than in the control group (P< 0.05). PGE2and MDA contents in the gastric mucosa in the observation group were different from those in the control group(P< 0.05). HAMA and HAMD scores were lower in the observation group than in the control group (P< 0.05). There was no difference of adverse reaction rate between the control group and the observation group (P>0.05). Conclusion Lansoprazole enteric-coated tablets combined with flupentixol-melitracen has better clinical efficacy than lansoprazole enteric-coated tablets only in patients with erosive gastritis and anxiety in terms of the improvement of clinical symptoms and mucosal erosion and the relief of negative emotions.

       焦虑症是最常见的精神障碍，区别于生理性焦虑，患者常表现出持续的焦虑状态。越来越多证据表明，抑制性神经元参与生理性焦虑的产生和消退，而这类神经元功能异常与焦虑症的发生密切相关。小清蛋白（PV）神经元是一类主要的抑制性中间神经元，广泛分布于大脑皮质和其他脑区，并且具有独特形态和功能。PV神经元可通过快速放电活动精确控制局部微环路和大脑网络活动，进而调控焦虑发生。文章综述PV神经元如何介导生理性焦虑及其功能异常及如何导致焦虑症的产生，重点介绍了PV神经元的解剖和功能特性，这些特性使它们拥有快速和强力的抑制作用，能够快速调控神经网络活动，和PV神经元以及相关的神经环路调控焦虑发生的环路机制，以及PV神经元调控焦虑发生的分子机制，并展望未来的研究方向，以期为开发新的焦虑症干预策略提供科学依据。

       Anxiety disorders，distinct from physiological anxiety，are characterized by a chronic and pervasive state of heightened anxiety and represent the most common mental diseases．Emerging evidence implicates inhibitory neurons in both the generation and extinction of physiological anxiety，with dysfunction in these neurons strongly associated with the pathogenesis of anxiety disorders．Among inhibitory neurons，parvalbumin（PV）-positive interneuron，a key subset with unique morphological and functional characteristics，are widely distributed across the cerebral cortex and various brain regions．These neurons exert rapid，potent inhibitory control over local microcircuits and broader neural networks through their fast-spiking activity，making them integral to the regulation of anxiety-related behaviors．This review highlights three key aspects：the anatomical and functional properties of PV neurons；their role in circuit mechanisms；the molecular pathways by which PV neurons regulate anxiety．By elucidating the role of PV neurons in modulating physiological anxiety and highlighting their dysfunction in anxiety disorders，this review aims to inform future research and foster the development of novel therapeutic interventions for anxiety disorders．