名医信箱：

    The famous doctor mailbox:

    我今年54岁，自1999年发病至今已十多年，常出现头痛、心慌、胸闷、心跳加快、出汗、手脚乏力和背痛等症状，浑身难受，但多次检查都一切正常。后来看心理科，医生说是抑郁症，开了一种叫百忧解的药，但吃了效果不明显，又转到神经内科治疗，有医生诊为是焦虑症，也有说是植物神经紊乱的。开了一种叫黛力新的药，吃了效果不错，但是到现在一直不能断药。不知道是不是因吃的时间太长了，目前药效已没有以前好。请问，我究竟得的是什么病？这种病是否要终生服药？

    I am 54 years of age,Since 1999, when the disease has been more than ten years,There is often a headache/palpitate/Chest tightness/Heart beats faster/sweating/Hands and feet and back pain and other symptoms,comfortable,But many times check everything is ok.Later to see psychiatrist,The doctor says is depression,Opened a medicine called prozac,But the effect is not obvious,He turned to the nerve internal medicine treatment,The doctor diagnosed as is anxiety,Also has is plant nerve disorder.A call Diana force new medicine,Ate the effect is good,But up to now has not broken.Don't know if because for too long,At present, the drug has not as good as before.Could you please tell me,I really have to is what disease?This disease is lifelong medication?

    一位苦恼人

    A distressed person

    解答：广东药学院附属第一医院心理科皇甫丽副教授、副主任医师

    answer:Associate professor of guangdong college of pharmacy affiliated first hospital psychiatrist HuangFuLi/Of doctor of vice director of

    焦虑症一般分发作性和持续性两种，前者包括惊恐发作和恐惧症，后者又叫广泛性焦虑。

    Anxiety and continuous two kinds of general distribution,The former include panic attacks and phobias,The latter is also called generalized anxiety.

    惊恐发作是指突发的比较强烈的紧张焦虑，有窒息感和失控感，好像有一种死亡将至、大难临头的感觉，类似冠心病发作，所以是急诊室的“常客”。恐惧症是指对外界的情境或事物感到恐惧，如社交恐惧、广场恐惧、恐高等。

    A panic attack is refers to the sudden strong anxious,Has a choking feeling and sense of control,If there is a kind of death will be to/disaster,Similar to coronary heart disease,So is the emergency room"Regular customers".Phobia means fear a situation or thing to the outside world,Such as social phobia/The square of fear/Afraid of high.

    广泛性焦虑是指泛化且持续的焦虑，该病不局限于特定的外部环境，患者莫名的总感到害怕、发抖、肌肉紧张、出汗、头晕、腹部不适等，过度担心，一种提心吊胆、惶恐不安的感觉，对外界刺激敏感、易激惹、难入睡、肌肉酸痛、胸闷气短、口干、尿意频繁等，以往常被称作为植物神经功能紊乱，是人群中比较常见的情绪障碍。世界卫生组织的一项研究表明，人群中焦虑症的终身患病率为13.6％~28.8％。其原因多种，多与个性特点和生活事件有关，比如性格比较急躁、敏感多疑、比较主观、缺乏安全感的人容易发生；遇到生活中的一些不顺利事件较多，有时受刺激程度较重本人承受力不够时容易发生；女性更年期内分泌紊乱时容易发生等。

    Generalized anxiety refers to generalization and constant anxiety,The disease is not limited to certain external environment,Patients with unexplained always afraid/trembling/Muscle tension/sweating/dizzy/Abdominal discomfort, etc.,Too much worry,A kind of scary/The feeling of fear,Is sensitive to external stimuli/irritability/Difficult to fall asleep/Muscle aches/Chest condition/Dry mouth/To urinate frequently, etc.,Known as plant nerve dysfunction in usual,Is a common mood disorders in the crowd.The world health organization (who), according to a study,The crowd anxiety lifetime prevalence of 13.6% ~ 13.6%.A variety of reason,How is associated with personality traits and life events,Such as character is impatient/Sensitive suspicious/subjective/Insecure people likely to happen;Encountered in life some event more smoothly,Sometimes the degree of stimulation heavier I tolerance is not easy to occur;Menopausal women easy to happen when the endocrine disorder, etc.

    广泛性焦虑症的治疗包括心理治疗和药物治疗。心理治疗花费时间长，起效慢，需要患者坚持配合；药物治疗起效快，症状缓解明显。一般医生需根据患者临床表现、相关测试结果以及接受度综合考虑治疗方案，多以心理治疗加药物治疗效果会更好。药物治疗疗程视患者病情而定，首发患者一般需要服药半年至1年时间，复发患者约需服1~2年，或终身服药。

    Generalized anxiety treatment including psychotherapy and drug treatment.Psychological treatment time is long,Work is slow,Need to keep on patients;Work fast drug treatment,Relieve symptoms.Usually the doctor need according to the clinical manifestations of patients/Relevant test results and acceptance considering treatment options,More than with psychotherapy and medication the effect will be better.Drug treatment depends on the patient condition,Starting with the general medicine need six months to 1 year,Recurrence patients need about 1 ~ 2 years,Or lifelong medication.

    根据您的来信，考虑是广泛性焦虑症。因病程较长，发病原因可能多种。采用单纯的心理治疗可能相对困难些，建议先辅以药物治疗，改善症状后结合心理治疗，这样在认知和个人成长方面会更全面彻底，治疗效果可能更好。广泛性焦虑症患者若及时全面接受治疗，预后相对较好；如因对本病认知度不够，治疗不连贯、不彻底，也会导致症状反复发作。您提到曾长期服用黛力新，初期效果好，后期稍差些，建议到心理专科复查一下，评估一下病情看是否需要调整药物。黛力新起效快副反应相对轻，患者容易接受，但仅对轻中度病人效果好些，对症状较重的患者需酌情加用其他药物。（记者翁淑贤 通讯员庄文斌、吴亮军）

    According to your letter,Considered to be generalized anxiety.Because of the long course of disease,Disease may be a variety of reasons.Using pure psychotherapy may be relatively difficult,Advice first supplemented by drug therapy,Improve symptoms after combining with psychological treatment,So in terms of cognitive and personal development will be more thorough,Therapeutic effect may be better.If patients with generalized anxiety comprehensive treatment in a timely manner,A relatively good prognosis;Awareness of the disease as a result of insufficient,Treatment is not consistent/Is not completely,Can also lead to recurrent symptoms.You mentioned once taking d force new for a long time,The early effect is good,Late a bit less,Specialist advice to the psychological review,Assess condition to see if need to adjust the medication.D force new work fast side effects are relatively light,Patient easy to accept,But only with mild-to-moderate patients the effect better,Needs to take into consideration the circumstances and in patients with symptoms of heavier with other drugs.(The reporter WengShuXian correspondent ZhuangWenBin/Wu Liangjun)