基于脑肠轴理论探讨调神和胃法辨治失眠症  

Discussion on the differentiation and treatment of insomnia by the method of regulating the mind and stomach based on brain-gut axis theory

作　　者：赵珮翡 陈少玫[2] 李嘉琪 韦启志 陈妙玲 ZHAO Peifei;CHEN Shaomei;LI Jiaqi;WEI Qizhi;ZHEN Miaoling

机构地区：[1]福建中医药大学,福建福州350122 [2]厦门市中医院,福建厦门361001

出　　处：《中医临床研究》2023年第33期55-58,共4页Clinical Journal Of Chinese Medicine

摘　　要：中医学对于失眠症病机的认识最早见于《素问•逆调论篇》记载的“胃不和则卧不安”。历代医家对其的阐述有阴阳说、神主论、心胃相关说及脑胃说等理论,皆强调脑与胃关系密切、相互影响。脑神主宰睡眠,而后天之本脾胃化生气血,可为脑神提供物质基础、滋养脑神活动。近年现代医学提出脑肠轴理论,脑肠轴对睡眠的影响涉及神经系统、内分泌系统、免疫系统及肠道菌群所介导的不同信息通路,分布于其中的脑肠肽也参与睡眠调节。中枢神经系统可通过脑肠轴传递冲动调节胃肠道功能,胃肠道亦可通过此通路反向影响中枢神经系统活动。脑肠轴理论通过对脑肠轴-微生物的认识,明确指出临床上失眠症与消化系统疾病密切相关,为历代至今“胃不和则卧不安”提供理论依据。历代至今“胃不和则卧不安”理论指导无数医家对失眠症的辨证思维及选方用药,而现代医学的脑肠轴理论进一步佐证脑胃同调、调神和胃辨治思路的可行性及科学性。文章基于脑肠轴理论,结合中医学内涵,探讨调神和胃法治疗失眠症,旨在强调从“脾胃”论治失眠症的重要性。The earliest understanding of the pathogenesis of insomnia in traditional Chinese medicine(TCM)is recorded in Suwen·Nidiao Lun(《素问•逆调论篇》),“Stomach disharmony makes sleeping uneasy”.TCM doctors of past generations have elaborated on this theory,such as Yinyang(阴阳)theory,brain-dominating theory,heart-stomach theory and brain-stomach theory,all of which emphasize the close relationship and mutual influence between the brain and the stomach.The brain dominates sleep,and the spleen and stomach transport and transform Qi(气)and blood,which can provide the material basis for the brain spirit and nourish the brain activity.In recent years,modern medicine has proposed the theory of brain-gut axis.The impact of brain-gut axis on sleep involves different information pathways mediated by neural system,endocrine system,immune system and intestinal flora.The central nervous system can regulate the function of the gastrointestinal tract by transmitting impulses through the brain-gut axis,and the gastrointestinal tract can negatively affect the activity of the central nervous system through this pathway.Through the understanding of brain-gut axis-microbe,the theory of brain-gut axis clearly points out that insomnia is closely related to digestive system diseases in clinical practice,providing a theoretical basis for“Stomach disharmony makes sleeping uneasy”.The theory of“Stomach disharmony makes sleeping uneasy”has guided the differential thinking and prescription selection of numerous doctors in the treatment of insomnia.The theory of gut-brain axis in modern medicine further supports the feasibility and scientificity of brain-stomach coordination,differentiation and treatment of regulating the spirit and stomach.Based on the theory of brain-gut axis and combined with the connotation of traditional Chinese medicine,this paper discusses the treatment of insomnia by regulating the mind and stomach,aiming to emphasize the importance of treating insomnia from the perspective of spleen and stomach

关 键 词：脑肠轴 调神和胃法 失眠症 

分 类 号：R256.23[医药卫生—中医内科学]