张佩江从相火论治不寐经验介绍  

Experience of ZHANG Peijiang in Treating Insomnia from the Perspective of Ministerial Fire

作　　者：李鹏超 吴明阳 张佩江(指导) LI Pengchao;WU Mingyang;ZHANG Peijiang(Instructor)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院),河南郑州1450002

出　　处：《新中医》2022年第24期212-215,共4页New Chinese Medicine

基　　金：河南省中医药传承与创新人才工程(仲景工程)中医药青苗人才培养项目(豫卫中医函[2021]16号)。

摘　　要：介绍张佩江教授从相火论治不寐的临床经验。张佩江教授认为,相火妄动而失其位则成贼火,邪火上扰心神,即成不寐之患。临床常见分型有相火妄动、相火郁遏、君相火旺、相火虚衰等,宜辨证施治。相火妄动者,宜引火归元,常以引火汤、封髓丹、补中益气汤加减施治;相火郁遏者,治当滋肾水、泻相火、升肝气,使心火下交于肾,可选二仙汤合甘麦大枣汤加减施治;君相火旺者,治当清心火、敛相火、滋肾阴,方选当归六黄汤加减施治,若火热日久炼液成痰,可选黄连温胆汤加减用之;相火虚衰者,治当温肾助阳、养心安神,可选金匮肾气丸加减施治。This paper introduces the clinical experience of Professor ZHANG Peijiang in treating insomnia from the perspective of ministerial fire. Professor ZHANG Peijiang believes that the frenetic stirring of ministerial fire loses its position and becomes thief fire,and that the pathogenic fire harassing the heart spirit leads to insomnia. The common clinical classification of types includes frenetic stirring of ministerial fire, constraint and obstruction of ministerial fire, vigorous sovereign fire and ministerial fire, and deficiency and debilitation of ministerial fire, etc., which should be treated according to syndrome differentiation. Those with frenetic stirring of ministerial fire should return fire to its source,and often be treated with modified Yinhuo Tang, Fengsui Pellets, and Buzhong Yiqi Tang. Those with constraint and obstruction of ministerial fire should be treated as nourishing the kidney water,draining the ministerial fire,raising the liver qi,so that the heart fire is handed down to restore interaction with the kidney. It can be treated by modified Erxian Tang and Ganmai Dazao Tang. Those with vigorous sovereign fire and ministerial fire should be treated to clear heart fire, restrain ministerial fire and enrich kidney yin, with modified Danggui Liuhuang Tang;if the fire-heat stays for a long time and fluid becomes phlegm, Huanglian Wendan Tang can be modified to treat. Those with deficiency and debilitation of ministerial fire should be treated by warming the kidney and assisting yang,nourishing the heart and calming the mind,and can be treated with Jingui Shenqi Pills.

关 键 词：不寐 从相火论治 相火妄动 相火郁遏 君相火旺 相火虚衰 张佩江 

分 类 号：R249[医药卫生—中医临床基础] R255.9[医药卫生—中医学]