摘要
赵瑞成教授认为,失眠以五脏不和为本,心神不安为标,倡导从五脏入手治疗失眠。心脾受损所致失眠多以虚证为主,以归脾汤为基础方治疗。从肝论治失眠主要分为4个证型:肝气郁滞证,肝郁化火证,肝血瘀阻证,肝阴亏耗证。肝郁气滞者予柴胡疏肝散;肝郁化火者予四逆散合龙胆泻肝汤加减;肝血瘀阻者予桃红四物汤加减;肝阴亏耗者可予钩芍通络汤配合酸枣仁汤加减。赵教授从肾阴虚、肾阳虚、心阴虚、心阳虚、心肾阴阳两虚5个方面论治心肾不交型失眠。肾阴不足者,方选黄连阿胶汤加减;肾阳不足者,方用交泰丸加减;心阴虚者,用黄连阿胶汤合交泰丸加减;心阳不足者,可用桂枝加桂汤;心肾阴阳两虚者,用桂附地黄丸加人参、沉香。若失眠患者肺气虚弱,在基础方中配合补肺汤;肝火扰心患者,在清肝泻火,镇心安神的同时可加用枇杷叶;肺肾阴虚,虚热扰心者,用生脉地黄饮加减。赵教授在药物治疗的同时,加用针灸治疗,常以百会、四神聪、安眠穴、神门、足三里、三阴交、照海、申脉为基础穴组,灵活取舍。
Professor Zhao Rui-cheng believes that the treatment of insomnia from the five zang-organs.For insomnia caused by damaged heart and spleen mainly due to deficiency syndrome,Spleen-Restoring is often used as the basic formula.Treatment of insomnia from liver can be divided into four syndrome types:stagnation of liver qi,stagnation of liver qi transforming into fire,stagnation of liver blood stasis,and deficiency of liver yin.For stagnation of liver qi,Bupleurum Liver-Soothing Powder is often adopted.For stagnation of liver qi transforming into fire,Frigid Extremities Powder combined with Modified Gentian Liver-Draining Decoction is often adopted.For stagnation of liver blood stasis,Modified Peach Kernel and Carthamus Four Substances Decoction is often adopted.For deficiency of liver yin,Ramulus Uncariae Cum Uncis and Radix Paeoniae Alba seu Rubra Collaterals-Dredging Decoction combined with Modified Sour Jujube Decoction is often adopted.Professor Zhao treats insomnia of heart-kidney non-interaction syndrome from five aspects:kidney yin deficiency,kidney yang deficiency,heart yin deficiency,heart yang deficiency and heart-kidney yin and yang deficiency.For kidney yin deficiency,Modified Coptis and Donkey-Hide Gelatin Decoction is often adopted.For kidney yang deficiency,Modified Jiaotai Pill(交泰丸,JTP)is often adopted.For heart yin deficiency,Coptis and Donkey-Hide Gelatin Decoction combined with Modified JTP is often adopted.For heart yang deficiency,Cinnamon Twig Decoction With Extra Cinnamon is often adopted.For heart-kidney yin and yang deficiency,Rehmannia Pill with Ramuli Cinnamomi and Aconiti Praeparatae Decoction plus Renshen(Radix Ginseng)and Chenxiang(Lignum Aquilariae Resinatum)is often adopted.For insomnia with deficient lung qi,Lung-Supplementing Decoction can be added to the basic formula.For insomnia with liver fire disturbing the heart,clearing the liver,purging the fire,calming the heart and tranquilizing mind together with Pipaye(Folium Eriobotryae)can be used.For lung-kidney yin deficiency w
作者
闫朝勃
赵瑞成
YAN Zhao-bo;ZHAO Rui-cheng(Hunan Academy of Chinese Medicine,Changsha,Hunan,China,410006)
出处
《河南中医》
2021年第4期552-557,共6页
Henan Traditional Chinese Medicine
基金
湖南省中医药科研计划项目(201639)。
关键词
失眠
针药结合
从心脾辨治
从心肝辨治
从肾辨治
从心肺辨治
赵瑞成
insomnia
combination of acupuncture and medicine
syndrome differentiation from heart and spleen
syndrome differentiation from heart and liver
syndrome differentiation from kidney
syndrome differentiation from heart and lung
Zhao Rui-cheng
