杨叔禹从肝脾论治失眠经验  

YANG Shuyu’s Experience in the Treatment of Insomnia:from the Liver and the Spleen

作　　者：李乐 杨叔禹(指导)[1] LI Le(The First Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen,361000)

机构地区：[1]厦门大学附属第一医院,福建省厦门市361000

出　　处：《中医杂志》2022年第23期2218-2222,共5页Journal of Traditional Chinese Medicine

基　　金：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[2022]75号);国家中医药管理局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);福建中医药大学校管课题临床专项(XB2021090)。

摘　　要：总结杨叔禹教授从肝脾论治失眠的临证经验。认为失眠与情志、脾胃密切相关,病位多责之于心、肝、脾三脏,关键病机为肝脾气机失调、心神受扰。提倡从肝脾论治,重在调畅气机、调和肝脾以安神助眠。针对痰热扰心、肝血亏虚、肝胆郁热、脾虚湿蕴、胃气失和五种不同证型,创制“疏泄系列方”,分别运用疏泄零号方(黄连温胆汤加减)清热化痰、疏肝理脾,疏泄一号方(酸枣仁汤合逍遥散加减)养血柔肝、健脾安神,疏泄六号方(柴胡加龙骨牡蛎汤加减)重镇平肝、调中安神,疏泄二号方(升阳益胃汤加减)运脾养肝,疏泄五号方(半夏泻心汤加减)降逆和中法。对于两种及以上证型兼夹的失眠,提倡择时服药和并病合方的诊疗思路。This paper summarized professor YANG Shuyu's experience in the treatment of insomnia from the liver and the spleen.It is believed that insomnia is inextricably linked to emotions and spleen-stomach,and this disease is mainly located at heart,liver and spleen;the key pathogenesis is qi movement disorder in liver and spleen,and harass of the heart spirit.It is advocated to treat insomnia from the liver and spleen,and to put focus on unblocking qi movement,and harmonizing the liver and spleen,so as to calm the mind and benefit sleep.In terms of the five syndromes of insomnia,such as phlegm-heat harassing the heart,liver blood depletion,liver-gallbladder constraint heat,spleen deficiency and damp accumulation,and stomach qi disharmony,“qi flow formulas”has been created and should be used,respectively,which were No.0 Formula,Modified Huanglian Wendan Decoction(黄连温胆汤加减)to clear heat and dissolve phlegm,soothe the liver and rectify the spleen;No.1 Formula,Modified Suanzaoren Decoction and Xiaoyao Powder(酸枣仁汤合逍遥散加减),to nourish the blood and soften the liver,fortify the spleen and calm the mind;No.6 Formula,Modified Chaihu and Longgu Muli Decoction(柴胡加龙骨牡蛎汤加减),to calm the liver with heavy sedatives,harmonize the center and calm the mind;No.2 Formula,Modified Shengyang Yifei Decoction(升阳益胃汤加减),to activate spleen and nourish liver;and No.5 Formula,Modified Banxia Xiexin Decoction(半夏泻心汤加减),to direct counterflow downward and harmonize the center.For insomnia with two or more syndrome types,it is advised to take medicine at the right time and combine the formulas.

关 键 词：失眠 气机失调 调和肝脾 名医经验 杨叔禹 

分 类 号：R256.23[医药卫生—中医内科学] R249[医药卫生—中医学]