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（郑 敏）
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内科学新进展 第十一章 内科领域的心身疾病
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摘 要 心身疾病也称心理生理疾病，是一组与精神紧张状态有关的躯体疾病。在这组疾病中，心理因素贯穿于疾病的整个过程，从病人发病前自身具有的疾病倾向，即易罹性，到直接发病、转归、预后，每一个阶段都与心理社会因素相联系。
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心理社会因素（应激）是导致发病的种子，通过合适的土壤（如个性因素、价值观、情绪等），最后发展成为心身疾病（结果）。在这个从种子到结果的过程中，其生长过程（生物中介机制）也是研究的重点。
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应激的生物中介机制与下丘脑—垂体—肾上腺轴、蓝斑—去甲肾上腺素／自主神经系统、下丘脑—垂体—性腺轴、下丘脑—垂体—生长激素轴、下丘脑—垂体—甲状腺轴等其他神经—内分泌系统以及免疫系统和凝血系统有关。
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根据《中国精神障碍分类与诊断标准第3版》的分类，心理因素相关生理障碍指一组与心理社会因素有关的以进食、睡眠及性行为异常为主的精神障碍。
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Abstract Psychosomatic disease also known as psychophysiological diseases, are a group of physical disease related to nervous state. In this group of diseases, psychological factors penetrate the entire process of the disease, from the liability of patients before the onset of the disease, to direct the incidence, outcome and prognosis, each of the stages is linked to psychological and social factors.
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Psychosocial factors（stress）is the seeds, through the appropriate soil（such as personality, values, emotions, and so on), and finally develop into a psychosomatic disease（the result). From seeds to outcome of the process, the growth of its（biological intermediation）is the focus of the study.
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The biological mechanisms of stress is linked to the hypothalamus-pituitary-adrenal axis, the blue plaque-norepinephrine / autonomic nervous system, the hypothalamus-pituitary-gonadal axis, the hypothalamus-pituitary-growth hormone axis, the hypothalamus-pituitary-thyroid, other neural endocrine system, immune system and clotting system.
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According to the the Chinese Classification and diagnostic criteria of Mental Disorders, Version 3, Physiological disorders related to psychological factors refer to a group of mental disorders characterized by the abnormality of eating, sleeping, and sexual behavior related to psychosocial factors.
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