王晓燕运用调和阴阳法治疗儿童不寐经验  

Wang Xiao-yan′s Experience of Treating Children′s Insomnia with Harmonizing Yin and Yang

作　　者：张艳梅 ZHANG Yan-mei(Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州市中医院,河南郑州450000

出　　处：《河南中医》2021年第9期1332-1335,共4页Henan Traditional Chinese Medicine

基　　金：第六批全国老中医药专家学术经验继承工作项目{国中医药人教发[2017]29号}。

摘　　要：王晓燕主任认为,不寐的基本病机为阴阳不和,与五脏有关,与心、肝、脾关系密切。儿童的年龄段不同,不寐致病特点也不一样,如婴幼儿阶段,饮食是主要致病因素,常以积滞实证为主;学龄前期及学龄期患儿,情志是主要致病因素,临床以实证、热证为主;青春期患儿,常见肝郁气滞、寒热、虚实错杂为主。实证多因食滞、痰浊、火热,重在消导和胃,化痰浊清热泻火,常用保和丸、黄连温胆汤等加减;心烦懊不得眠,常用栀子豉汤加减。虚证多由于阴血不足,重在心、脾、肝、肾,治宜补养气血,壮水制火,常用百合地黄汤、归脾汤、黄连阿胶汤等加减;阴阳失调,常用桂枝龙骨牡蛎汤加减。王老师认为,治疗不寐重在辨其有邪无邪,实证虚证,常从"肝脾"论治,配合清心、养心安神,方选逍遥散或丹栀逍遥散加半夏秫米汤。Director Wang Xiao-yan believes that the basic pathogenesis of insomnia is disharmony between yin and Yang, which is related to the five zang organs and closely related to the heart, liver and spleen.The pathogenic characteristics of insomnia vary with the age of children: In the infant stage, diet is the main pathogenic factor, which is often dominated by food accumulation.In preschool and school-age children, emotion is the main pathogenic factor, and excess syndrome and heat syndrome are the main clinical factors.In adolescent children, liver depression and qi stagnation, cold and heat, deficiency and excess in complexity are common.Excess syndrome is mainly due to food stagnation, phlegm turbidity and fire heat.The treatment focuses on promoting digestion and removing food stagnation, eliminating phlegm and harmonizing stomach, resolving phlegm turbidity, clearing heat and purging fire, so Harmony-Preserving Pill, Modified Coptis Gallbladder-Warming Decoction are commonly used.For those who are upset and can′t sleep, Modified Gardenia and Semen Sojae Praeparatum Decoction is often used.Deficiency syndrome mainly focuses on the heart, spleen, liver and kidney due to the lack of yin blood.It is suitable to nourish qi and blood, supplement water to inhibit fire, so Lily Bulb and Rehmannia Decoction, Spleen-Restoring Decoction, Coptis and Colla Corii Asini Decoction, etc.are often used for modification.For disharmony between yin and Yang, Modified Cinnamon Twig and Os Draconis and Concha Ostreae Decoction can be used.Professor Wang believes that the treatment of insomnia focuses on distinguishing whether it has pathogen or not, and it is excess syndrome or deficiency syndrome.It is often treated from "liver and spleen",combined with clearing the heart, nourishing the heart and calming the mind.Free Wanderer Powder, or Cortex Moutan and Fructus Gardeniae Free Wanderer Powder combined with Pinellia Decoction are often adopted.

关 键 词：儿童不寐 调和阴阳法 半夏秫米汤 保和丸 黄连温胆汤 栀子豉汤 百合地黄汤 归脾汤 黄连阿胶汤 桂枝龙骨牡蛎汤 逍遥散 丹栀逍遥散 王晓燕 

分 类 号：R272.6[医药卫生—中医儿科学]