夏中伟教授基于“肝体阴而用阳”运用三合汤治疗失眠经验  

Professor XIA Zhongwei’s experience in treating insomnia with the Sanhe decoction based on the theory of“liver belongs to Yin in physique and Yang in function”

作　　者：田甜 李飞泽 TIAN Tian

机构地区：[1]浙江中医药大学第三临床医学院,浙江舟山316000 [2]浙江中医药大学附属舟山市中医院,浙江舟山316000

出　　处：《中医临床研究》2025年第2期84-88,共5页Clinical Journal Of Chinese Medicine

基　　金：2022年全国名老中医药专家传承工作室建设项目李飞泽全国名老中医药专家传承工作室(国中医药人教函[2022]75号);第七批全国老中医药专家学术经验继承工作指导老师及继承人项目(国中医药人教函[2022]76号)。

摘　　要：失眠是多种因素导致的睡眠障碍,属于临床常见病、多发病,严重影响患者的生命健康和生活质量。西医治疗失眠效果欠佳,中医药辨证论治失眠已被证实具有明显优势。夏中伟教授躬耕杏林,精研医理,认为失眠是典型的形神同病,发生发展与精神情志存在密切关系,主要病机是肝体用失调,肝疏泄失常,郁而化火,扰乱心神,肝阴血不足,无以濡养心神,诊疗应在“肝体阴而用阳”理论的基础上疏肝解郁、养血安神。夏教授将《金匮要略》中的方剂广泛应用于临床,并承古方而不拘泥于古方,运用酸枣仁汤、百合地黄汤和甘麦大枣汤加减拟定三合汤治疗失眠。该方疏肝开郁、养血安神,清热养阴和行气活血并举,标本兼顾,与“肝体阴而用阳”理论紧密联系,内容丰富,配伍严谨,组方精良。临床根据实际情况酌情加减用药能够充分发挥方药的价值,体现了中医治疗的灵活变通。同时,夏教授主张整体把握,身心同治,施治过程中对患者进行心理干预,嘱患者进行生活调摄,取得良好疗效。文章介绍验案一则,总结夏中伟教授治疗失眠的理法方药,为临床提供新思路。Insomnia is a sleep disorder caused by a variety of factors,which is a common clinical disease and frequently-occurring disease,seriously affecting the life health and quality of life of patients.Western medicine is not effective in the treatment of insomnia.The treatment of insomnia based on traditional Chinese medicine syndrome differentiation has been proved to have obvious advantages.Professor XIA Zhongwei is well versed in medical science.She believes that insomnia is a typical disease of both physical and mental illness,and its occurrence and development are closely related to spiritual emotions,and that the main pathogenesis is the disorder of physique and function of liver,causing the mind to be disturbed due to liver fire after abnormal liver drainage,blood deficiency of liver can not nourish the mind.The diagnosis and treatment should be based on the theory of“liver belongs to Yin(阴)in physique and Yang(阳)in function”to soothe liver depression,nourish blood and calm the mind.Based on a good understanding of TCM classics and the accumulation of clinical practice,Professor XIA is good at widely applying the prescriptions in Jingui Yaolue(《金匮要略》)in clinical practice,and following the ancient prescriptions rather than sticking to them.The Suanzaoren decoction(酸枣仁汤),the Baihe Dihuang decoction(百合地黄汤)and the Ganmai Dazao decoction(甘麦大枣汤)were used by the professor to prescribe the Sanhe decoction(三合汤)to treat insomnia.This prescription has the functions of soothing liver depression,nourishing blood and calming the mind,clearing heat and nourishing Yin,and promoting Qi(气)circulation and activating blood at the same time,taking into account treating both principal and secondary aspect of diseases,and is closely related to the theory of“liver belongs to Yin in physique and Yang in function”,with rich content,strict compatibility,and sophisticated composition.Adding or subtracting medicine according to the actual situation can give full play to the utiliz

关 键 词：失眠 肝体阴而用阳 名医经验 

分 类 号：R256.23[医药卫生—中医内科学]