摘要
介绍蔡慎初教授治疗不寐的临床经验。不寐以心肾不交型最为多见,且多以“温肾水,泻心火”治疗。蔡慎初教授则认为,心肾上下交损之际,当治其中,概括其病机有三:痰湿阻滞,升降失和;气血亏虚,心肾无资;寒热虚实错杂,气机逆乱。治则治方有三:注重化痰,调畅枢机,方选半夏厚朴汤、枳术丸、半夏秫米汤合方加减;补气养血,建中为要,黄芪建中汤合桂枝甘草龙骨牡蛎汤加减;寒热同调,虚实兼顾,方选半夏泻心汤合酸枣仁汤为主方。故诊治不囿于心肾,把握整体,从中焦脾胃论治,运用经方合方化裁。
This paper introduces the clinical experience of Professor CAI Shenchu treating insomnia. The common type of insomnia is heart-kidney non-interaction type,and the main treatment is to warm the kidney water and drain the heart fire.Professor CAI holds that the middle should be treated when there is non-interaction between the heart and the kidney. There are three pathogenesis of the disease,namely phlegm-damp obstruction and the disorder of upward and downward,qiblood deficiency and lack of nourishing in the heart and the kidney,and cold,heat,deficiency and excess in complexity and derangement of qi movement. There are three treatment principles and methods;the treatment should pay attention to resolving phlegm and regulating qi movement,and the modified combination of Banxia Houpu tang,Zhishu pills and Banxia Shumi tang should be applied;the patients should supplement qi and nourish blood, focus on the consolidation of the middle,and be treated with modified Huangqi Jianzhong tang and Guizhi Gancao Longgu Muli tang;cold and heat as well as deficiency and excess should be regulated,and the main prescription is Banxia Xiexin tang and Suanzaoren tang. Therefore,the treatment should not be limited to the heart and the kidney,but to grasp the whole with syndrome differentiation and treatment of the middle energizer,the spleen,and stomach,and modified use of classical prescriptions.
作者
黄佳杰
袁拯忠
李运博
单卓程
叶人
HUANG Jiajie;YUAN Zhengzhong;LI Yunbo;SHAN Zhuocheng;YE Ren
出处
《新中医》
CAS
2022年第8期240-242,F0003,共4页
New Chinese Medicine
基金
国家自然科学基金资助项目(81673733)
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2019]41号)。
关键词
不寐
心肾不交
脾胃
蔡慎初
Insomnia
Heart-kidney non-interaction
Spleen and stomach
CAI Shenchu
