基于“血实宜决之”辨治老年慢性失眠  

Treatment of Chronic Insomnia in the Elderly Based on“Blood Excess Should Be Dissolved”

作　　者：卞旭东 赵晓东[1] 高芳玲 温豆 杨秀元 李颖瑜 丁霞[2] BIAN Xudong;ZHAO Xiaodong;GAO Fangling;WEN Dou;YANG Xiuyuan;LI Yingyu;DING Xia(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学,北京100029

出　　处：《山东中医杂志》2024年第10期1079-1083,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(编号:2018YFC1704106);北京中医药大学孙思邈研究院资助项目(编号:SSMYJY-2-2021-12)。

摘　　要：“血实宜决之”出自《素问·阴阳应象大论》,意为通过针药并用祛邪逐瘀以治疗血瘀壅滞等血实之象。慢性失眠是老年人的常见病,瘀血内阻是老年慢性失眠的核心病机。临床治疗老年慢性失眠可遵循“血实宜决之”治则,以血府逐瘀汤为基础方,根据肝郁、痰火、阴虚、气虚、血虚等不同致瘀原因加减化裁,同时配合针刺、耳穴等疗法,以提高疗效。“Blood excess should be dissolved”comes from Plain Conversation·Major Discussion on the Theory of Yin and Yang and the Coresponding Relationships Among All the Things in Nature,which refers to that the symptoms of blood stasis and blood stagnation are treated with acupuncture and medicine.Chronic insomnia is a common disease in the elderly,and internal accumulation of blood stasis is the core pathogenesis of chronic insomnia in the elderly.Clinical treatment of chronic insomnia in the elderly can follow the treatment principle of“blood excess should be dissolved”and Xuefu Zhuyu Decoction(血府逐瘀汤)is given as the basic prescription,which is modified according to different causes of blood stasis such as liver stagnation,phlegm fire,yin deficiency,qi deficiency,and blood deficiency,etc.At the same time,acupuncture,auricular points and other therapies can be combined to improve the curative efficacy.

关 键 词：血实宜决之 瘀血 老年慢性失眠 血府逐瘀汤 肝郁 痰火 阴虚 气虚 血虚 

分 类 号：R256.23[医药卫生—中医内科学]