基于“肝主卫气”探讨从肝辨治失眠  

Discussion on the Treatment of Insomnia from Liver Based on the Theory"Liver Governs Wei Qi(Defensive Qi)"

作　　者：李梓荣 王妙然 吴宇飞 倪恬 王宪贝 杜泓瑾 张继伟[2] 李秋艳[2] LI Zirong;WANG Miaoran;WU Yufei;Ni Tian;WANG Xianbei;DU Hongjin;ZHANG Jiwei;LI Qiuyan(Graduate School of Beijing University of Chinese Medicine,Beijing,100029;Xiyuan Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京中医药大学研究生院,北京市100029 [2]中国中医科学院西苑医院

出　　处：《中医杂志》2025年第4期411-415,共5页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第四届国医大师传承工作室和第二届全国名中医传承工作室建设项目;北京市中医管理局北京中医药薪火传承“新3+3”工程。

摘　　要：目前精神心理因素已经成为失眠发病和进展的重要因素,从“肝主卫气”角度探讨从肝论治失眠的辨治思路。将“肝主卫气”内涵概括为肝助脾胃运化、主卫气生成;肝助肺气宣发、主卫气输布;肝调昼夜节律、主卫气循行三方面。并提出临床治疗失眠应调肝疏五脏,助卫气循行,常用入肝经之柴胡、白芍、栀子、酸枣仁等;养肝分昼夜,顺卫气节律,常用百合、合欢、夜交藤之类;畅肝重心身,使卫气得安,临证提倡言语疏导、精神调摄、健康教育。最终使肝气可疏,气机得畅,卫气可行,昼夜得调,阴阳相交,不寐可愈。Psychological factors have become significant contributors to the onset and progression of insomnia.This article explored the treatment of insomnia from the perspective of“liver governs wei qi(defensive qi)”.The concept of“liver governs wei qi(defensive qi)”is summarized in three aspects,firstly,the liver assists the spleen and stomach in transformation and transportation,governing the generation of wei qi;secondly,the liver aids lung qi diffusion and dispersion,governing the distribution of wei qi;thirdly,the liver regulates circadian rhythms,governing the circulation of wei qi.It is proposed that the clinical treatment of insomnia should focus on the following methods:for regulating the liver to harmonize the five viscera,and facilitate the circulation of wei qi,medicinals entering the liver channel include Chaihu(Bupleuri radix),Baishao(Paeoniae Radix Alba),Zhizi(Gardeniae Fructus),and Suanzaoren(Ziziphi Spinosae Semen)could be commonly used;for nourishing the liver,the treatment should align with the daynight rhythm,and herbs such as Baihe(Lilium),Hehuan(Albizia julibrissin),and Yejiaoteng(Polygoni multiflori caulis)are commonly used;for soothing the liver and address both mental and physical health to calm wei qi,treatment should advocate verbal counseling,psychological regulation,and health education.Ultimately,this treatment approach can free liver qi to flow,soothe qi movement,restore the motion of wei qi,regulate during day and night,balance yin and yang,and resolve insomnia effectively.

关 键 词：失眠 不寐 肝主卫气 心身同调 

分 类 号：R256.23[医药卫生—中医内科学]