基于中医五神理论辨治脑卒中后失眠症  

Diagnosis and Treatment of Post-Stroke Insomnia Based on the Theory of Five Spirits in Chinese Medicine

作　　者：刘晋 苏振华 滕晶 LIU Jin;SU Zhenhua;TENG Jing(The First School of Clinical Medicine of Shandong University of Traditional Chinese Medicine,Ji'nan Shandong 250000,China;Dapartment of Neurology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan Shandong 250000,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250000 [2]山东中医药大学附属医院神经内科,山东济南250000

出　　处：《新中医》2024年第23期193-196,共4页New Chinese Medicine

基　　金：山东省重点研发项目(2021LCZX06)。

摘　　要：脑卒中后失眠症是脑卒中的常见并发症之一,对脑卒中的治疗及预后有重要影响。中医认为脑卒中后失眠症是典型的形神共病疾病,其发病与中医神、魂、魄、意、志五神异常关系密切。文章阐述了中医神、魂、魄、意、志五神理论体系及中医五神与脑卒中后失眠症的关联内容。中医五神理论认为脑卒中后失眠症的病机可概括为神亢意任、魂强魄弱以及志用不足3大类,以安神平意、安魂益魄、补精填志为治则,临床可选用朱砂安神丸、琥珀多寐丸、河车大造丸等加减方治疗,可为临床诊疗脑卒中后失眠症提供新的思路与方法。Post-stroke insomnia is one of the common complications of stroke,which has a significant impact on the treatment and prognosis of stroke.Chinese medicine believes that post-stroke insomnia is a typical comorbidity of body and spirit,and its onset is closely related to the abnormality of the five spirits in Chinese medicine:spirit,ethereal soul,corporeal soul,reflection,and will.The article introduces the theoretical system of the five spirits of Chinese medicine,namely the spirit,ethereal soul,corporeal soul,reflection,and will,as well as the correlation between the five spirits of Chinese medicine and post-stroke insomnia.The theory of five spirits in Chinese medicine suggests that the pathogenesis of post-stroke insomnia can be summarized into three categories:hyperactivity of the spirit and the reflection,strong ethereal soul and weak ethereal soul,and insufficient use of the will.The treatment principles include calming the spirit and the reflection,calming ethereal soul and nourishing corporeal soul,and supplementing essence and filling the will.Clinically,modified prescriptions such as modified Zhusha Anshen Pills,Hupo Duomei Pills and Heche Dazao Pills can be used to treat post-stroke insomnia,thus providing new ideas and methods for clinical diagnosis and treatment.

关 键 词：脑卒中后失眠症 中医五神 朱砂安神丸 琥珀多寐丸 河车大造丸 

分 类 号：R256.23[医药卫生—中医内科学]