孙建光从肝胆论治不寐临证经验  

SUN Jianguang’s clinical experience in treating insomnia from liver and gallbladder

作　　者：卢文杰 孙建光[2] LU Wenjie

机构地区：[1]山东中医药大学,山东济南250000 [2]山东中医药大学附属医院,山东济南250000

出　　处：《中医临床研究》2024年第8期90-93,共4页Clinical Journal Of Chinese Medicine

基　　金：山东省2019-2020年度中医药科技发展计划项目(经方专项)(2019-0962);山东省重点研发计划(重大科技创新工程)(2021CXGC010510)。

摘　　要：不寐是由于情志、饮食等诸多原因引起的以睡眠时长和(或)深度不足为主要表现的病证。轻者表现为入睡困难、眠浅易醒,或者醒后不能复寐,甚者可彻夜不寐,长期反复发作则严重影响患者的身心健康和生活质量。随着现代人们生活节奏的加快和饮食习惯的改变,越来越多的患者开始深受不寐困扰。不寐发病与情志不畅、饮食不节、年老体弱、思虑劳倦等因素关系密切。现代医家认为本病总属阴盛阳衰、阴阳失交,病机关键在于心火不能下通于肾,肾水不能上济于心,在治疗上多以心肾论治。孙建光教授是山东中医药大学博士生导师,师承尹常健教授、王文正教授,从事中医临床、教育、科研工作二十余年,临证多从肝胆论治不寐,每收良效。孙建光教授认为肝气郁滞不畅常为不寐起病的始动因素,在此基础上又可化火、生痰、化瘀,导致痰、火、瘀等多病理因素夹杂,病情进一步发展则出现肝虚之证,并兼有心、脾、肾多脏腑失养,故切不可单以心肾为治。临证常以调理气机为辨治基础,酌施疏肝护肝之法,治病求本,随证施以清热利湿、化痰降浊、活血化瘀等诸法。对于顽固性失眠或久病不愈的患者重视补肝、健脾、养心、滋肾,且在此基础上尤为重视调养脾胃,顾护中焦,收效颇丰。Insomnia is a condition caused by many reasons such as mood and diet,mainly manifested by insufficient sleep duration and(or)depth.Mild cases are manifested as difficulty falling asleep,shallow sleep and easy to wake up,or can not return to sleep after waking up,or may not even be able to sleep at night.Long-term recurrent attacks seriously affect the patient’s physical and mental health and quality of life.With the acceleration of the pace of modern people’s life and the change of eating habits,more and more people are beginning to suffer from insomnia.The onset of insomnia is closely related to factors such as poor mood,improper diet,old age and infirmity,and fatigue.Modern medical practitioners believe that the disease is most caused by the prosperous Yin(阴)or the weak Yang(阳),then Yin and Yang are out of touch.They believe that the key to the disease is that the heart fire can not go down to the kidney,kidney water can not nourish the heart,and the treatment is mostly based on the heart and kidney.Professor SUN Jianguang is a doctoral supervisor of Shandong University of Traditional Chinese Medicine,under the tutelage of Professor YIN Changjian and Professor WANG Wenzheng,has been engaged in the clinical education and scientific research of traditional Chinese medicine for more than 20 years.Professor SUN Jianguang believes that the stagnation of liver Qi(气)is often the starting factor of the onset of insomnia.And on this basis,it can produce fire,phlegm,and stasis and other pathological factors.Further progression of the disease will lead to liver Qi deficiency,and then cause damage of heart,spleen,kidney organs.Therefore,the heart and kidney must not be treated alone.The clinical treatment is often based on regulating the Qi as the basis of differentiation and treatment,the method of dredging the liver Qi and protecting the liver is adopted as appropriate,for seeking the root before treating the disease,and applying various methods such as clearing heat and moisture,dissolving phlegm and reducing

关 键 词：不寐 从肝胆论治 肝主疏泄 辨证论治 

分 类 号：R256.23[医药卫生—中医内科学]