基于阴阳体用关系试述针灸治疗围绝经期失眠的临床思路  

Clinical Thinking of Acupuncture and Moxibustion in the Treatment of Perimenopausal Insomnia Based on Essence-function Relationship between Yin and Yang

作　　者：粟胜勇[1] 张熙 覃美相 林媛媛 蔡慧倩 王甜[2] SU Shengyong;ZHANG Xi;QIN Meixiang;LIN Yuanyuan;CAI Huiqian;WANG Tian(The Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学第一附属医院,南宁530023 [2]广西中医药大学,南宁530001

出　　处：《世界中医药》2022年第10期1415-1418,共4页World Chinese Medicine

基　　金：国家自然科学基金地区科学基金项目(81960895,81460745);广西自然科学基金面上项目(2018GXNSFAA281111)。

摘　　要：以阴阳体用关系为理论指导,从调整阴阳使其回归本位的角度出发,分析围绝经期失眠阳不入阴的关键影响因素,论述基于阴阳体用关系指导下针灸治疗围绝经期失眠的临床思路。围绝经期阴虚、阳虚或阴阳两虚均可导致阳气浮越于外上,不能顺利潜藏于内下本位,阳不入阴而发为失眠,是围绝经期失眠的主要病因病机,就此提出协调阳气下潜,使其回归本位,恢复“内阳外阴”本体结构的治疗原则,在临床上结合三焦的生理功能,形成清上焦以泻浮阳、运中焦助阳下潜、补下焦以纳阳归阴的针灸治疗方案,通过使浮越于外、上的阳气顺利潜藏于内、下本位,恢复“内阳外阴”的本体结构,阳得以入阴而治疗本病。Under the theoretical guidance of the essence-function relationship between yin and yang and from the point of view of adjusting yin and yang to return to the standard,the present study analyzed the key influencing factors of perimenopausal insomnia that yang fails in promoting yin,and discussed the clinical thinking of acupuncture and moxibustion in the treatment of perimenopausal insomnia.Yin deficiency,yang deficiency,or deficiency of both yin and yang in the perimenopausal period can cause yang qi to float upward,deviating from the inner site downward.Insomnia occurs when yang fails in promoting yin,which is the main etiology and pathogenesis of perimenopausal insomnia.Therefore,this study put forward the treatment principle of coordinating the descending of yang and restoring the original structure of“internal yang and external yin”.Additionally,based on the physiological functions of triple energizers,this study proposed the treatment protocol of acupuncture and moxibustion,i.e.,purging floating yang by clearing upper energizer,descending yang by activating middle energizer,and improving yang and returning yin by tonifying lower energizer,and expounded treatment thinking of this disease by descending the external floating yang to the inner site to restore the structure of“internal yang and external yin”.

关 键 词：阴阳体用关系 内阳外阴 外阳内阴 针灸 三焦 围绝经期失眠 临床思路 

分 类 号：R246[医药卫生—针灸推拿学] R256.23[医药卫生—中医临床基础]