亚健康失眠的中医辨证分型及临床用药思路  

Traditional Chinese Medicine Syndrome Differentiation of Insomnia in Suboptimal Health and Clinical Medication Ideas

作　　者：杨熠文 夏立营[2] 张建军[3] 杨柏灿[1] YANG Yiwen;XIA Liying;ZHANG Jianjun;YANG Baican(Academy of Chinese Materia Medica,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]上海中医药大学中药学院,上海201203 [2]中国中医科学院西苑医院,北京100091 [3]北京中医药大学,北京100029

出　　处：《世界中医药》2024年第12期1816-1819,共4页World Chinese Medicine

基　　金：国家重点研发计划中医药现代化研究重点专项(2018YFC1706800);国家自然科学基金项目(82204642)。

摘　　要：失眠是亚健康状态的主要表现之一。在病因病机上可归于劳逸失度、阴血亏耗,情志不舒、肝郁化火,饮食偏嗜、痰湿内生3方面。在中医证型上可分为心神失养证、火扰心神证、气郁痰阻证3型。针对亚健康失眠的中医保健,应以辨证保健为主结合对症保健。辨证保健上以利尿导热、滋阴降火法清心安神缩短入睡时间,以补虚敛神、益精养血法养心安神维持睡眠深度,以理气化痰、利胆和胃法疏泄通滞调节寐寤表现;对症保健上以重镇与甘缓类药物改善烦躁不宁、心神不安的表现,以导阳入阴药物改善节律紊乱症状,实现辨证、对症相结合。Insomnia is one of the main manifestations of suboptimal health.It is caused by imbalance between work and rest which leads to the consumption of yin and blood,emotional disorder which leads to the transformation of fire from liver depression,and imbalanced diet habits which lead to the generation of phlegm and dampness.The patients with insomnia mainly present the traditional Chinese medicine(TCM) syndromes of heart deprived of nourishment,fire harassing heart spirit,and qi stagnation and phlegm obstruction.Intervention measures for insomnia should be taken based on syndrome and symptom differentiation.In terms of healthcare based on syndrome differentiation,the method of promoting urination and clearing heat or nourishing yin and reducing fire should be adopted to shorten the time to fall in sleep;the method of tonifying deficiency and restraining mind or replenishing essence and tonifying blood can be taken to improve the sleep quality;and the method of regulating qi movement and resolving phlegm or promoting bile secretion and harmonizing stomach can be taken to dredge stagnation and regulate sleeping and awakening.In terms of healthcare based on symptom differentiation,medicines with tranquilizing and soothing effects can be taken to mitigate restlessness and irritability,and the medicines with the effects of guiding yang into yin can be used to repair the disorder of circadian rhythm.

关 键 词：辨证保健 失眠 亚健康 中药 心神失养证 火扰心神证 气郁痰阻证 对症保健 

分 类 号：R256.23[医药卫生—中医内科学]