国医大师韩明向从肝肾论治帕金森病失眠经验  

TCM master HAN Mingxiang’s clinical experience in treating insomnia after Parkinson’s disease from the aspect of liver and kidney

作　　者：杨宇 侯志峰[2] YANG Yu

机构地区：[1]安徽中医药大学,安徽合肥230031 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医临床研究》2025年第1期130-134,共5页Clinical Journal Of Chinese Medicine

基　　金：2023年度安徽省卫生健康科研项目(No.AHWJ2023A20281)。

摘　　要：文章主要总结韩明向教授从肝肾论治帕金森病失眠的经验。失眠作为帕金森病最为普遍的非运动症状之一,显著影响帕金森病患者的生活质量。韩明向教授为第四届国医大师、首届全国名中医,在多年临床诊疗实践中重视病机转化,认为帕金森病失眠以肝肾阴虚为核心病机,兼有肝郁血虚、阴阳失和。韩教授从脏腑病因病机、治法要点、临证用药等多个方面进行分析,强调以“滋阴补肾,疏肝养血,调整阴阳”为基本治则,临床经验组方独具特色。针对帕金森病失眠肝肾阴虚证,方用天麻钩藤饮合杞菊地黄汤加减以滋阴补肾、平肝息风、宁心安神。对于肝郁血虚证,方用柴胡疏肝散合酸枣仁汤加减以疏肝养血,补心安神。对于阴阳失和证,方用滋水清肝饮加减以滋养肾阴、清泻肝火、平衡阴阳。同时重视依据病情变化调整用药,如对于彻夜难眠者可加龙骨、牡蛎以安心神。韩明向教授强调临证治疗帕金森病失眠时既要重视患者运动症状的改善,也要聚焦其非运动症状,从整体入手,把握病机变化,做到同病异治,知常达变,如此才能使患者阴平阳秘,夜寐得安,从而提高其生活质量。Prof.HAN Mingxiang’s clinical experience in treating insomnia in Parkinson’s disease from the aspect of liver and kidney is summarized in this paper.Insomnia,as one of the most common non-motor symptoms of Parkinson’s disease,has a significant impact on the quality of life of Parkinson’s disease patients.Prof.HAN Mingxiang,one of the fourth TCM masters,and one of the first National Famous TCM Practitioners,emphasizes the transformation of pathogenesis during years of clinical diagnosis and treatment practice,and believes that the core pathogenesis of insomnia after Parkinson’s disease is Yin(阴)deficiency of liver and kidney,accompanied by liver depression and blood deficiency,and Yin-Yang(阳)disharmony.From the analysis of the etiology and pathogenesis of Zang-Fu organs(脏腑),key points of treatment,clinical medication,etc.,Prof.HAN emphasizes that nourishing Yin and tonifying the kidney,dredging liver and nourishing blood,and adjusting Yin and Yang is the basic treatment principle.The clinical experienced prescription is unique.For insomnia after Parkinson’s disease with Yin deficiency of liver and kidney,Tianma Gouteng Yin(天麻钩藤饮)plus the Qiju Dihuang decoction(杞菊地黄汤)is used to nourish Yin and tonify kidney,calm the liver wind,and tranquilize the mind.For liver depression and blood deficiency syndrome,Chaihu Shugan San(柴胡疏肝散)plus the Suanzaoren decoction is used to soothe liver and nourish blood,and nourish heart and tranquilize mind.For Yin-Yang disharmony syndrome,Zishui Qinggan Yin(滋水清肝饮)is mainly used to nourish kidney Yin,and clear liver fire,so as to balance Yin and Yang.At the same time,it is emphasized to adjust the medication according to the changes of the condition,such as adding Longgu(Os Draconis)and Muli(Concha Ostreae)to tranquilize the mind.Prof.HAN Mingxiang emphasizes that in the clinical treatment of insomnia after Parkinson’s disease,it is important to pay attention to the amelioration of motor symptoms as well as non-motor symptoms o

关 键 词：帕金森病 失眠 临证经验 

分 类 号：R256.23[医药卫生—中医内科学]