“六郁”学说在针刺治疗失眠中的应用  

Clinical Application of Six Yu Theory in Treatment of Insomnia with Acupuncture

作　　者：高源洁 赵建新 GAO Yuanjie;ZHAO Jianxin(The Third Clinical Hospital of Beijing University of Chinese Medicine,Beijing China 100029;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]北京中医药大学第三临床医学院,北京100029 [2]北京中医药大学第三附属医院,北京100029

出　　处：《中医学报》2023年第7期1428-1432,共5页Acta Chinese Medicine

基　　金：北京市中医管理局“寿小云名医传承工作站分站”建设项目{京中医科字[2020]16号}。

摘　　要：针刺治疗失眠的一般思路是调和阴阳、调神和脏腑辨证,而从六郁角度论治失眠则更加关注人体气机运行和血瘀、痰湿、食积等病理产物的郁滞状态。针刺的作用基础是调畅气血、疏通经络,故其长于顺气开郁。在临床治疗过程中需要注意的是,首先,六郁以气郁为先,无论何种郁病都要兼顾调畅一身气机,以顺气开郁为总纲,如加用合谷-太冲“开四关”;其次,朱丹溪认为“凡郁皆在中焦”,中焦脾胃是气机升降的枢纽,若脾失健运、胃失和降,则会逐步演化出气郁、食郁、火郁、湿郁、痰郁、血郁,故针刺治疗时当注重调理中焦,如加刺中脘或足三里。此外,在治郁病的同时,可配合百会、神庭、神门、内关等穴安神助眠。The general idea of acupuncture in treatment of insomnia is to reconcile Yin and Yang,regulate the spirit and differentiation of Zan-fu organs,while in treatment of insomnia from the perspective of Liu Yu,the movement of Qi and the stagnation of pathological products such as blood stasis,phlegm and dampness,and food accumulation are paid more attention.The working basis of acupuncture is to regulate Qi and blood and dredge meridians,so it is good at regulating Qi and relieving depression.In the process of clinical treatment,it is necessary to know the followings:first of all,Qi depression should be removed first.No matter what kind of depression the regulation of a Qi activity should be taken into account,with Qi open depression as the general principle,such as the use of Hegu-Taichong acupoints to open"four doors".Secondly,Zhu Danxi believed that"all depression is in the Middle Jiao",in which Spleen and Stomach is the hub of Qi movement.I the Spleen is not healthy,Stomach Qi is not normally down,Qi depression,food depression,Fire depression,Damp depression,Phlegm depression and blood depression would be evolved gradually.Therefore,in acupuncture treatment the conditioning of the Middle Jiao should be paid attention to in treatment,such as acupunction on Xhongwan and Zusanli.In addition,in treatment of depression,acupoints of Baihui,Shenting,Shenmen and Neiguan should also be used to help sleep.

关 键 词：失眠 “六郁”学说 针刺 气郁 食郁 火郁 湿郁 痰郁 血郁 

分 类 号：R255.9[医药卫生—中医内科学]