气机升降理论内涵及不寐病辨证分型探讨  

Discussion on the theory of qi movement and differentiation of symptoms and signs in insomnia

作　　者：周芳[1,2] 张栋[2] 马剑然[2] 金海涛 李智杰[1,2] 刘玲 ZHOU Fang;ZHANG Dong;MA Jianran;JIN Haitao;LI Zhijie;LIU Ling(Hubei University of Chinese Medicine,Wuhan 430070,China)

机构地区：[1]湖北中医药大学,湖北武汉430070 [2]武汉市中医医院,湖北武汉430050

出　　处：《陕西中医》2024年第1期88-91,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(2018FYC1705602);武汉市卫生健康委员会青年项目(WZ22Q50,WZ22Q52)。

摘　　要：气机升降理论是“汉派李氏脑病流派”辨治不寐病的核心理论思想,基于气机升降理论将不寐病分为升降太过和升降不及两大类,根据气机运行的部位、气的多少、气机升降出入的不同形式将不寐病分为营卫不和型、脏腑气机失调型、阴阳不交型三大类型;每一类型又有各自不同亚型,共有卫阳虚不敛营阴证、卫气盛夜不入营阴证、卫气入于阴而日不得出于阳证、肝胆气机疏泄失调证、心肾气机上下相济失调证、脾升胃降枢机失调证、阳不入阴证、阳盛阴虚证、阴不潜阳证九种亚型,并表现出各自独有的临床特征。基于气机升降理论的辨证分型法补充完善了现阶段不寐病辨证分型类别,为临床诊治不寐病开拓了新思路。The theory of qi movement is the core theoretical idea of“Li’s school of encephalopathy of the Han school”in treating insomnia.Based on the theory of qi movement,insomnia is divided into two categories:excessive rise and fall and insufficient rise and fall.According to the parts where qi moves,the amount of qi,and the different forms of qi movement in and out,the insomnia disease can be divided into three types:Yingwei disharmony type,viscera qi movement disorder type,and yin and yang disharmony type.Each type has its own different subtypes,nine subtypes in total,namely the type in which Wei yang is deficient and does not absorb Yin,the type in which Wei qi is strong and does not enter Yin at night,the type in which Wei qi enters Yin but cannot come out of Yang during the day,types of liver and gallbladder qi movement disorders,types of heart and kidney qi movement disorders of up and down coordination,types of spleen ascending and stomach descending central movement disorders,types of yang not entering yin,types of yang excess and yin deficiency,and types of yin not subduing yang.Each type exhibits unique clinical features.The syndrome differentiation and classification method based on the theory of qi movement complements and improves the current syndrome differentiation and classification of insomnia diseases,and opens up new ideas for the clinical diagnosis and treatment of insomnia diseases.

关 键 词：不寐病 气机升降理论 汉派李氏脑病流派 辨证分型 营卫不和证 脏腑气机失调证 阴阳不交证 

分 类 号：R256.23[医药卫生—中医内科学]