从“火郁发之”论治失眠  

Treatment of Insomnia from"Dispersing Fire Stagnation"

作　　者：柴树艳 赵悦[1] 柴智琦 田紫阳 张家瑞 庞敏[2] 高静[2] CHAI Shuyan;ZHAO Yue;CHAI Zhiqi;TIAN Ziyang;ZHANG Jiarui;PANG Min;GAO Jing(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,Liaoning,China;The second affiliated Hospital of Liaoning University of traditional Chinese Medicine,Shenyang 110034,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁沈阳110034

出　　处：《实用中医内科杂志》2024年第11期50-52,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家重点研发计划项目(2018YFC1704100);东北部地区名老中医学术观点、特色诊疗方法和重大疾病防治经验研究项目(2018YFC1704105)。

摘　　要：现代人由于情志因素、饮食习惯及年龄因素等原因易产生火热之邪。而纵观失眠发生的原因,“火郁”是导致失眠的重要病因,“火郁”导致气机不畅,阴阳失交,阳不入阴发为不寐。“火郁发之”理论首见于《黄帝内经》,是热性病证的重要治疗原则之一,后世医家对其多有阐发。“火郁发之”理论强调治疗火郁之证时,因势利导,审因辨治,解郁散火,畅达气机,从而使机体恢复“阴平阳秘”的状态。升降散来源于杨栗山所著《伤寒瘟疫条辨》,是温病十五方之首,其辨证关键在于只要属于气机失调,无论寒热虚实。栀子豉汤为《伤寒论》中“火郁发之”的代表方剂。文章以中医经典理论“火郁发之”为切入点,探讨失眠的有效治则治法,以期丰富失眠的临床诊疗思路。Modern people are prone to fire evil due to emotional factors,eating habits and age factors.Looking at the causes of insomnia,"fire depression"is an important cause of insomnia,"Dispersing Fire Stagnation"leads to poor Qi,Yin and Yang loss,Yang does not enter Yin for insomnia.The theory of"Dispersing Fire Stagnation"first appeared in the Huangdi Neijing,which is one of the important treatment principles of hot disease.The theory of"fDispersing Fire Stagnation"emphasizes that when treating the syndrome of fire depression,it is necessary to guide the situation,examine the cause and distinguish the treatment,dispel the depression and disperse the fire,and reach the Qi machine,so that the body can restore the state of"Yinping Yang secret".Shengjiang Decoction(升降散)is the first of the fifteen ways of febrile disease.The key of the syndrome differentiation lies in the disorder of Qi,regardless of cold heat and deficiency.Zhizichi Decoction(栀子豉汤)is the representative prescription of"Dispersing Fire Stagnation"in Shanghanlun.In this paper,the classic theory of traditional Chinese medicine"Dispersing Fire Stagnation"as the starting point,to explore the effective treatment of insomnia,in order to enrich the clinical diagnosis and treatment of insomnia.

关 键 词：火郁发之 失眠 升降散 栀子豉汤 

分 类 号：R256.23[医药卫生—中医内科学]