刘克勤运用加味五苓散治疗失眠症验案一则  

LIU Keqin’s experience in treating insomnia with the modified Wuling powder

作　　者：谭天祥 刘克勤[2] 邬媛 TAN Tianxiang

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省太原市中医医院,山西太原030009

出　　处：《中医临床研究》2023年第20期82-85,共4页Clinical Journal Of Chinese Medicine

摘　　要：睡眠是维持身心健康的关键生理过程。良好的注意力、反应力、学习和记忆力等都需要高质量的睡眠保证。睡眠还参与内分泌代谢以及免疫系统调节等。失眠患者往往靠安眠药入睡,安眠药镇静作用强、起效迅速,但存在不良反应。相比之下,中药具有良好的安全性和镇静作用。五苓散见于《伤寒论》,其中包含桂枝、白术、泽泻、猪苓、茯苓五味药物,具有利湿行水、温阳化气之功,主治太阳蓄水证。文章从三个方面具体论述了失眠的睡眠机理和病因病机,从营卫阴阳的角度,提出除了应用安神药物外,也可通过祛除水湿之邪,调节水液代谢,从治理肺脾肾出发,调理阴阳而达到安眠的效果,为临床医生提供辨证治疗思路。并通过验案一则,介绍山西省太原市中医医院刘克勤主任运用加味五苓散治疗失眠的经验,以期为临床提供参考。Sleep is an essential process to maintain physical and mental health.Good cognitive performance including attention,responsiveness,learning and memory,all require high-quality sleep.It also participates in the endocrine system metabolism and the regulation of immune system.Insomnia seriously affects people’s life,but sleeping pills have strong sedative effect and rapid onset,but have side effects and other adverse reactions.In contrast,TCM has good safety and sedative properties.The Wuling powder(五苓散)is derived from Shanghan Lun(《伤寒论》)and composed of five herbs:Guizhi(Ramulus Cinnamomi),Baizhu(Rhizoma Atractylodis Macrocephalae),Zexie(Rhizoma Alismatis),Zhuling(Polyporus),Fuling(Poria).It has the function of warming Yang(阳),transforming Qi(气),promoting dampness and flowing water.This paper specifically discusses the sleep mechanism and etiology of insomnia from three aspects,and proposes that in addition to the application of tranquilizing drugs,it can also be achieved by removing the evil of water and moisture,regulating water metabolism,and regulating Yin(阴)and Yang from the treatment of lungs,spleen and kidneys,so as to provide clinicians with dialectical treatment ideas.Through the case of using the Wuling powder for the treatment of insomnia,the experience of LIU Keqin,director of Taiyuan Traditional Chinese Medicine Hospital in Shanxi Province,in the treatment of insomnia is introduced,in order to provide clinical reference.

关 键 词：五苓散 失眠 不寐 验案 

分 类 号：R256.23[医药卫生—中医内科学]