基于“方证相应”理论浅析经方治疗失眠  

Analysis of Insomnia Treatment Based on Theory of Formula and Syndrome Corresponding

作　　者：许宏平 黄古叶[2] 梅露 吴玉莹 陈华林 莫柏林 XU Hongping;HUANG Guye;MEI Lu;WU Yuying;CHEN Hualin;MO Bolin(Guangxi University of Chinese Medicine,Nanning Guangxi China,530000;The First Affiliated Hospital to Guangxi University of Chinese Medicine,Nanning Guangxi China 530000)

机构地区：[1]广西中医药大学,广西南宁530000 [2]广西中医药大学第一附属医院,广西南宁530000

出　　处：《中医学报》2024年第9期1876-1880,共5页Acta Chinese Medicine

摘　　要：源于《伤寒论》的方证相应理论,即指方剂的中药组成及其配伍规律与所治疾病的主要病机或病症之间高度相关,而方证之间的对应程度直接决定疾病的疗效。失眠是临床常见疾病和症状,病因复杂,中医对失眠的治疗历史悠久。《伤寒论》中治疗不寐的经方桂枝甘草龙骨牡蛎汤、柴胡加龙骨牡蛎汤、半夏泻心汤、黄连阿胶汤、酸枣仁汤均具有调阴阳、安心神的作用,主要适用于治疗实证或虚实夹杂之不寐。其中,桂枝甘草龙骨牡蛎汤主要用于治疗心阳不足所致的不寐,柴胡加龙骨牡蛎汤主要用于治疗久病、胸满烦惊之不寐,半夏泻心汤主要用于治疗胃虚痞满导致的不寐,黄连阿胶汤主要用于治疗阴虚火旺、虚烦不寐,酸枣仁汤主要用于治疗虚劳不眠。The treatment is originated from the theory of formula and syndrome corresponding in Shang Han Lun,which refers to the high correlation between the composition of Chinese medicine and its compatibility with the main pathogenesis or symptoms of the disease treated,and the corresponding degree between the formula and the syndrome directly determines the clinical efficacy in treating the disease.Insomnia is a common clinical disease or symptom with complex etiology,and Chinese medicine has a long history of treating insomnia.In Shang Han Lun,the prescriptions created by Zhang Zhongjing,such as Guizhi Gancao Longgu Muli Decoction,Chaihu plus Longgu Muli Decoction,Banxia Xingxin Decoction,Huanglian Ejiao Decoction and Suanzaoren Decoction,all have the effect of regulating Yin and Yang as well as easing the mind,and they are mainly suitable for the treatment of sleeplessness with excess syndrome or mixture of deficiency and excess syndrome.Among them,Guizhi Gancao Longgu Muli Decoction is mainly used to treat insomnia caused by Heart Yang deficiency,Chaihu plus Longgu Muli Decoction is mainly used to treat insomnia caused by long-term illness and chest fullness,anxiety and frightening,Banxia Xingxin Decoction is mainly used to treat insomnia caused by Stomach deficiency with distention and fullness,Huanglian Ejiao Decoction is mainly used to treat insomnia with Yin deficiency and inner Fire syndrome,and Suanzaoren Decoction is mainly used to treat sleeplessness caused by fatigue.

关 键 词：失眠 方证相应 桂枝甘草龙骨牡蛎汤 柴胡加龙骨牡蛎汤 半夏泻心汤 黄连阿胶汤 酸枣仁汤 《伤寒论》 张仲景 

分 类 号：R256.23[医药卫生—中医内科学]