从“土枢四象,一气周流”理论论治失眠  

Discuss Insomnia from the Theory of"Qi Cycle in Round,Soil Pivot Four Organs"

作　　者：赵冀校 李鹏英[1] ZHAO Jixiao;LI Pengying(Beijing University of Chinese Medicine,Bejjing China 100029)

机构地区：[1]北京中医药大学,北京100029

出　　处：《中医学报》2021年第11期2302-2305,共4页Acta Chinese Medicine

基　　金：北京中医药大学新奥奖励基金项目(2017-XAJLJJ-006)。

摘　　要：黄元御“土枢四象,一气周流”理论指:土为水、火、金、木四象之母而实生四象,为气血生化之源,一身气机之枢纽,四象的运化输布皆依赖于土气的枢转;气机的升降出入运动周而复始、如环无端。失眠病多因阴阳失调、气血失和引起,病因涉及五脏六腑、气血津液。应用黄元御“土枢四象,一气周流”理论可将失眠分为三种类型诊治,即左右出入障碍引起的肝郁木陷、肺金不降型失眠;上下升降功能障碍引起的肾水沉寒、心火上炎型失眠;中焦升降失职引起的脾土湿困、四象失运型失眠。临证时以黄元御核心药甘草、茯苓、半夏为基础,肝郁木陷、肺金不降型失眠可加调肝理肺安神之品;肾水沉寒、心火上炎型失眠可加养心补肾安神之品;脾土湿困、四象失运型失眠可加培土和胃安神之品。Huang Yuanyu′s theory of"qi cycle in round,soil pivot four organs"means that soil is the mother of the four organs of water,fire,gold and wood,and produces the four organs.It is the source of qi and blood biochemistry and the pivot of qi movement.The transportation and distribution of the four organs all depend on the pivoting of soil qi.The ascending,descending,in and out movement of qi movement goes round and round,like a ring without end.Insomnia is mostly caused by the imbalance of yin,yang,qi and blood.The etiology involves the five zang and six fu organs,qi,blood and body fluid.Applying Huang Yuanyu′s theory of"qi cycle in round,soil pivot four organs",insomnia can be divided into three types:insomnia caused by liver depression and not descending of lung qi caused by left and right access obstacles;insomnia caused by kidney water sinking cold and heart fire inflammation caused by up and down dysfunction;insomnia caused by spleen dampness,dysfunction in transport of four organs caused by dereliction of functiong in lifting and lowering of the middle Jiao.Clinically,based on Huang′s core medicines such an Gancao(licorice),Fuling(Poria cocos)and Banxia(Pinellia ternata),insomnia of liver depression and not descending of lung qi can be added medicine to regulate liver,regulate lung and calm mind;insomnia with kidney water sinking cold and heart fire inflammation can be added medicine to nourish the heart,tonify the kidney and calm the mind;insomnia of spleen dampness and dysfunction in transport of four organs can be added medicine to cultivate soil,harmonize the stomach,and calm the mind.

关 键 词：“土枢四象 一气周流” 失眠 肝郁木陷 肾水沉寒 脾土湿困 黄元御 《四圣心源》 

分 类 号：R256.23[医药卫生—中医内科学]