基于“一气周流、土枢四象”理论探讨中医治疗不寐病思路  

Investigating the Approach to Managing Sleeplessness Within Traditional Chinese Medicine Guided by the Concept of"Single Qi Flow and the Quadrants of the Terrestrial Pivot"

作　　者：马鹤鸣 孙善斌[2] MA Heming;SUN Shanbin(Fengyang County Hospital of Traditional Chinese Medicine,Anhui Fengyang 233100,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230088,China)

机构地区：[1]安徽省凤阳县中医院,安徽凤阳233100 [2]安徽中医药大学第二附属医院,安徽合肥230088

出　　处：《中医药临床杂志》2025年第3期399-404,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：孙善斌安徽省名中医工作室项目(皖中医药发展秘﹝2023﹞23号);安徽省第13批“115”产业创新团队“针药结合防治脑病产业创新团队项目”(皖人才办[2020]4号)。

摘　　要：清代黄元御认为人体升降的核心是五脏六腑的升降运动。肝肾居下焦而主乎升,遂其升发之权;心肺居上焦而主乎降,行其肃降之令;脾胃居于中焦,左旋右转,为升降之枢纽,传化精微以溉四旁。而“一气”分阴阳,阳出于阴则作,入于阴则眠,阴阳平衡被打破或结合位点异常是不寐发生的根本病因病机。阴阳本是相对而言,“左右者,阴阳之道路也。”可以理解为左路为阳起到“兴奋”的作用,而右路为阴起到“抑制”的作用。对于“不寐”的临床治疗,应遵从阴阳左右二路本身的特性以及患者自身情况,注重中土的升降功能及一身气机的流畅。Huang Yuanyu of the Qing Dynasty believed that the core of the rise and fall of the human body is the rise and fall movement of the five internal organs and six bowels.The liver and kidney are located in the lower part of the body and are responsible for rise and fall,and they have the power to rise and send forth;the heart and lung are lo-cated in the upper part of the body and are responsible for descent and carry out the order of descending and descend-ing;the spleen and stomach are located in the middle part of the body,rotating left and right,and are the hubs of rise and fall,transmitting and transforming the essence to irrigate the four sides.The“one Qi”is divided into Yin and Yang.When yang comes out of Yin,it works,and when it enters Yin,it sleeps.The fundamental cause and pathogenesis of insomnia is that the balance of Yin and Yang is broken or the binding sites are abnormal.Yin and yang are originally relative,and“left and right are the roads of Yin and Yang.”It can be understood that the left road is yang and plays an“exciting”role,while the right road is Yin and plays an“inhibiting”role.For the clinical treatment of“insomnia”,we should follow the characteristics of the two roads of Yin and Yang and the patient’s own conditions,and pay attention to the rise and fall function of the middle earth and the smoothness of the whole body’s Qi.

关 键 词：一气周流 土枢四象 升降出入 不寐 

分 类 号：R221[医药卫生—中医基础理论]