摘要
[目的]探究从胆论治焦虑性失眠的思路和方法,为焦虑性失眠的辨治提供新思路。[方法]通过对相关古今文献资料进行分析、归纳,总结从胆论治焦虑性失眠的理论基础。根据胆的基本生理特点和研究记载,推导得出胆病不寐的主要病机。再结合历代医家的临床经验,逐步归纳出从胆论治焦虑性失眠的具体思路和遣方用药的方法,最后附上医案二则予以验证。[结果]焦虑性失眠以伴有焦虑症状的失眠为主要表现,而胆具有司勇怯、主决断、调睡眠的生理功能,因此从胆论治焦虑性失眠在理论上具有可行性。从生理特征上来看,胆以阳升阴降为和;从病理变化来看,阳虚阴实、升降失司为胆病的基本病机,因此从胆论治焦虑性失眠当以调和阴阳、升清降浊为基本原则。所举验案一为胆寒阳浮之不寐,治宜温化少阳、镇摄浮阳,方选柴芩温胆汤加减;验案二为胆阳虚之不寐,治当以温胆升阳为则,方选柴胡桂枝汤加减,治疗后效果明显。[结论]从胆论治焦虑性失眠紧扣病机,疗效可观,为中医辨治失眠提供了一个新思路,丰富了中医论治失眠的理论内容。
[Objective] To explore the ideas and methods of treating anxiety insomnia from the perspective of gallbladder,and to provide new ideas for the identification and treatment of anxiety insomnia. [Methods] Through analyzing and summarizing the relevant ancient and modern literatures,the theoretical basis of treating anxiety insomnia from the gallbladder was summarized. According to the basic physiological characteristics and research records of gallbladder,the main pathogenesis of gallbladder insomnia was deduced. Combined with the clinical experience of doctors in previous dynasties,this paper gradually concluded the specific thinking and prescription medication method of treating anxiety insomnia from the gallbladder,and finally attached two medical cases for verification. [Results]Anxiety insomnia is mainly manifested by insomnia with anxiety symptoms,and the physiological functions of gallbladder,determination and sleep regulation make it theoretically feasible to treat anxiety insomnia from the gallbladder. In terms of physiological characteristics,the gallbladder is composed of Yang rising and Yin falling. The basic pathogenesis of gallbladder is Yang deficiency and Yin excess,and failing to ascend and descend. Therefore,the basic principle of treating anxiety insomnia based on gallbladder is to harmonize Yin and Yang,ascend clear and descend turbid. The first case was the insomnia due to the cold of gallbladder and Yang floating,and the treatment was to warm Shaoyang and calm the floating Yang,and Chaiqin Wendan Decoction plus or minus was adopted;the second case was insomnia due to deficiency of gallbladder Yang,the treatment should be based on warming the gallbladder and promoting Yang,and Chaihu Guizhi Decoction plus or minus was adopted. Both effects were obvious after treatment. [Conclusion] The treatment of anxiety insomnia from the gallbladder is closely related to the pathogenesis,the curative effect is considerable,which provides a new idea for the treatment of insomnia in traditional Chinese medicine,enriches the theoretical content of the treatment of insomnia in traditional Chinese medicine.
作者
张一鸣
叶发
张永华
ZHANG Yiming;YE Fa;ZHANG Yonghua(Guangxing Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou(310007),China)
出处
《浙江中医药大学学报》
CAS
2021年第3期209-213,共5页
Journal of Zhejiang Chinese Medical University
基金
浙江省中医药现代化专项项目(2020ZX013)。
关键词
焦虑性失眠
不寐病
从胆论治
调和阴阳
升清降浊
温胆汤
柴胡桂枝汤
医案
anxiety insomnia
insomnia
treatment from the gallbladder
harmonizing Yin and Yang
ascend clear and descend turbid
Wendan Decoction
Chaihu Guizhi Decoction
medical records
