张振贤教授基于“昼精夜瞑”理论辨治不寐病  

Differentiating and Treating Insomnia by Professor ZHANG Zhenxian Based on‘Zhou Jing Ye Ming’

作　　者：张瑞[1] 黄瑶[2] 史佳宁[2] 陈敏[2] 葛文金 蒋天君 张振贤[2] ZHANG Rui;HUANG Yao;SHI Jianing;CHEN Min;GE Wenjin;JIANG Tianjun;ZHANG Zhenxian(Jiading Hospital of Traditional Chinese Medicine,Shanghai 201800,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai China)

机构地区：[1]上海市嘉定区中医医院,上海201800 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中医药信息》2023年第6期23-26,共4页Information on Traditional Chinese Medicine

基　　金：上海市嘉定区自然基金项目(JDKW20200017);上海市卫生健康委员会上海市中医药管理局上海市中医药事业发展三年行动计划(2018-2020年)医疗机构治未病服务能力提升项目[ZY(2018-2020)-ZWB-1001];上海市嘉定区中医重点专科项目(2020-JDZYYZDZK-03)。

摘　　要：不寐是指睡眠时间或质量不足,主要表现为入睡困难,或睡眠维持障碍、睡眠质量下降和总睡眠时间减少,同时伴有日间功能障碍。人的睡眠觉醒节律与自然界相应,“昼精夜瞑”是正常睡眠觉醒节律状态,即白天精力旺盛,夜晚沉睡安眠。张振贤教授经过长期临床实践运用中医药辨治不寐病,发现阴阳平衡、气血调和是正常睡眠发生的基本要素,不寐的主要病机责之于阴阳失衡、气血失常,以致睡眠觉醒节律紊乱,出现卫气白昼出营阴不利“昼不精”、卫气夜晚入营阴不利“夜不瞑”等病理现象。病位与五脏相关,辨证强调“五脏藏神”。临证重在恢复患者“昼精夜瞑”状态,总结出“育阴潜阳,水火相济”“调和气血,贯穿始终”“衷中参西,身心同治”等治疗原则,注重精神调摄,诊治中遵循五脏一体,形神合一,圆机活法,以致阴平阳秘、精神归平。Insomnia refers to the lack of sleep time or good sleep quality,mainly manifested as difficulty in falling asleep,or disorders of sleep maintenance,reduction of sleep quality and total sleep time,accompanied by daytime dysfunction.Sleep rhythm is corresponded with the nature of'Zhou Jing Ye Ming'(vigor during daytime and sleep at night)of normal sleep-wake rhythm state.Professor ZHANG Zhenxian has unique insights in syndrome differentiation and treatment of insomnia.During long time clinical practice,ZHANG found the balance of Yin and Yang and the harmony of Qi and blood are the basic elements of normal sleep.The cause of insomnia was mainly due to the imbalance between Yin and Yang,as well as the disorder of Qi and blood.The disorders of sleep and wake rhythms represent'Zhou Bu Jing'(lack of vigor during daytime)and'Ye Bu Ming'(not sleep at night)and other pathological phenomena.The location of the disease is related to five-Zang organs.Syndrome differentiation of insomina emphasizes five-Zang organs storing SHEN.The treatment of insomnia is to recover the state of vigorous state during daytime and deep sleep at night.ZHANG summarized the treatment principals of raising Yin and submerging Yang to harmonize water and fire,regulating Qi and blood throughout the whole treatment period,combined with treating physical body and mental based on integrated Chinese and Western medicine.The holism treatment rule of five-Zang organs and the unity of physical and mental should be paid attention to.She mastered the mechanism and treatment methods of insomnia very well to balance Yin and Yang,as well as to improve Shen.

关 键 词：失眠 昼精夜瞑 名医经验 张振贤 

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