张晋基于开阖枢理论探讨血府逐瘀汤治疗失眠  

Zhang Jin′s Experience in Treating Insomnia with Xuefu Zhuyu Decoction Based on Theory of Pivot Opening and Closing

作　　者：栗文婕 邱林杰 任燕 李美洁 李纪新 张晋[2] LI Wenjie;QIU Linjie;REN Yan;LI Meijie;LI Jixin;ZHANG Jin(The First School of Clinical Medicine,Shanxi University of Chinese Medicine,Taiyuan Shanxi China 030024;Xiyuan Hospital Affiliated to China Academy of Chinese Medical Sciences,Beijing China 100091;Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]山西中医药大学第一临床学院,山西太原030024 [2]中国中医科学院西苑医院,北京100091 [3]北京中医药大学,北京100029

出　　处：《中医学报》2025年第4期836-841,共6页Acta Chinese Medicine

基　　金：中国中医科学院科技创新工程项目(CI2021A03005);北京中医药薪火传承“3+3”工程项目:施奠邦名家研究室项目(2023-SZ-A-51);山西中医药大学优硕创新计划项目(2022YS013);国家中医药管理局全国中医优秀临床人才研修项目{国中医药人教发〔2017〕24号}。

摘　　要：张晋教授基于《黄帝内经》三阴三阳开阖枢理论,认为失眠病机总归于三阴三阳运行交接失常,提出“双阖双枢失常,阴阳不交致失眠”,并结合六经欲解时概念将其病机表现划分为三,即阳明不降,少阴难枢;厥阴不阖,少阳浮动;双枢不利,阴阳难交。临证结合开阖枢的时空观,以血府逐瘀汤为基础方,随六经病理偏重灵活加减治疗失眠,多有效验。Based on the theory of pivot opening and closing within framework of the three Yin and three Yang in Huang Di Nei Jing,Prof.Zhang Jin believes the pathogenesis of insomnia can be attributed to the malfunction of the three Yin and three Yang."The double closure and double pivot are out of order,and Yin and Yang don′t intermingle,which results in insomnia."In addition,with the concept of the six meridians conditions when disease being relieved,the pathogenesis of insomnia can be divided into three kinds,namely,Yangming not descending induced Shaoyin′s pivot problem;Jueyin not closing caused Shaoyang floating;unfavorable double pivots induced not communicating between Yin and Yang.In clinical practice,by combining the temporal and spatial concepts of pivot opening and closing,modified Xuefu Zhuyu Decoction can be used in treatment of insomnia,according to the pathology of the six meridians.It is effective in treatment of the disease.

关 键 词：失眠 血府逐瘀汤 开阖枢理论 张晋 

分 类 号：R249.27[医药卫生—中医临床基础]