从水、火、气、血辨治失眠  

Treating insomnia from fluid,fire,qi and blood syndrome

作　　者：陈金秀 张晓轩 管桦桦 徐碧云 胡媛媛 孙晨 徐福平 原嘉民 杨志敏 CHEN Jinxiu;ZHANG Xiaoxuan;GUAN Huahua;XU Biyun;HU Yuanyuan;SUN Chen;XU Fuping;YUAN Jiamin;YANG Zhimin(The Second Clinical School of Guangzhou University of Chinese Medicine,Guangzhou 510105,China;Co-constrction National Laboratory of Traditional Chinese Medicine Dampness Syndrome(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine),Guangzhou 510120,China;The Third People’s Hospital of Zhongshan,Zhongshan 528400,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510105 [2]省部共建中医湿证国家重点实验室(广州中医药大学第二附属医院),广州510120 [3]中山市第三人民医院,中山528400

出　　处：《中华中医药杂志》2025年第1期261-264,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：2020年国家中医药管理局中医药古籍文献和特色技术传承专项(No.GZY-KJS-2020-071);广州市科学技术局基础研究计划项目(No.2023A03J0734,No.2023A03J0754);广东省中医药局中医药科研项目(No.20212091,No.20241129);广东省基础与应用基础研究基金企业联合基金(No.2022A1515220073)。

摘　　要：基于营卫失和的失眠病机及许家栋教授的津液输布异常而变生四证理论,杨志敏教授提出可把失眠分为水证、火证、气证、血证,根据津液的来源和去路导致的输布失常,把四证分为不足和有余两大类进行辨治,并依不同证的病机特点随证治之。不足之水证以温补中焦为先,有余之水证以温阳化饮为要;不足之火证治以清热补津,有余之火证依病位脏腑清热泻火;不足之气证宜健运中焦,有余之气证当协调升降;不足之血证应养营补血,有余之血证宜祛瘀生新。从四证入手,对于临证辨治该病具有一定的临床意义。Based on the pathogenesis of insomnia due to Ying Wei disharmony,and XU Jiadong's theory of the four syndromes of fluid disorders,professor YANG Zhimin proposes that insomnia can be divided into fluid,fire,qi and blood syndrome,and the four syndromes can be divided into two categories,deficiency and sthenic syndrome,according to the source and destination of fluid disorders,and treated according to the characteristics of the pathogenesis of each syndrome.Insufficient fluid syndrome is treated by warming and tonifying the middle jiao,while surplus fluid syndrome is treated by warming the yang and resolving fluid retention;deficient fire syndrome is treated by clearing heat and promoting fluid production,while surplus fire syndrome is treated by clearing heat and dipping fire according to the location of Zang Fu;deficient qi syndrome is treated by building and transporting the middle jiao,while surplus qi syndrome is treated by harmonizing the rise and fall;deficient blood syndrome is treated by nourishing the ying and tonifying the blood,while surplus blood syndrome is treated by removing blood stasis for promoting tissue regeneration.Starting from the four syndromes,it has certain clinical significance for the clinical diagnosis and treatment of the disease.

关 键 词：失眠 营卫失和 水证 火证 气证 血证 津液 

分 类 号：R256.23[医药卫生—中医内科学]