黄挺教授基于“阳不入阴”辨治阳虚型癌因性失眠经验  

Professor HUANG Ting’s Clinical Experience in Treating Yang-Deficiency Cancer-Related Insomnia Based on the Theory of“Yang Not Entering Yin”

作　　者：黄杰[1] 周河燃 黄挺[2] 赵浩羽 宋灿洋 徐天翔 HUANG Jie;ZHOU Heran;HUANG Ting(Hangzhou Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou(310012),China;Hangzhou Municipal TCM Hospital)

机构地区：[1]浙江中医药大学杭州临床医学院,杭州310012 [2]杭州市中医院 [3]浙江中医药大学第二临床医学院

出　　处：《浙江中医药大学学报》2025年第3期322-325,350,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划项目(2021ZB193)。

摘　　要：[目的]基于“阳不入阴”理论探析黄挺教授诊治阳虚型癌因性失眠的经验。[方法]通过临床跟师、整理医案,并查阅古籍文献,从理论溯源、病因病机、辨证论治、理法方药等方面分析黄教授诊治阳虚型癌因性失眠的临床经验,另附2则医案加以佐证。[结果]黄挺教授认为肿瘤实为阴邪,易耗阳气,故癌因性失眠多可辨为阳虚不寐,并强调以脏腑辨证为要,脾胃阳虚、心阳亏虚为切入点,总结提出“通阳健运以入阴”“温阳宁心以养神”的治法总纲,分别以补中益气汤、桂甘龙牡汤合甘麦大枣汤为主方,随症化裁。文中验案一辨为脾虚湿盛,治以温中祛湿;验案二辨为心阳亏虚,治以温阳安神,疗效显著。[结论]黄挺教授从阳虚辨治癌因性失眠,细辨脏腑,标本兼顾,效果显著,值得临床借鉴与学习。[ObjectiveObjective]To summarize Professor HUANG Ting’s clinical experience in treating Yang-deficiency cancer-related insomnia,focusing on“Yang not entering Yin.”[MethodsMethods]The clinical apprenticeship,case review and literature review of ancient texts were conducted to analyze Professor HUANG’s clinical experience in treating this condition from aspects of etiology,pathogenesis,treatment principles and prescriptions,supplemented by case studies as evidence.[ResultsResults]Professor HUANG considers tumors to be Yin pathogenic factors that easily consume Yang Qi,hence cancer-related insomnia in clinical practice is often diagnosed as Yang-deficiency insomnia.He emphasizes the importance of organs differentiation,particularly focusing on spleen and stomach Yang deficiency and heart Yang deficiency as the entry points and summarizes and proposes the general treatment principles of“promoting Yang to facilitate Yin entry”and“warming Yang to nourish the spirit”with Buzhong Yiqi Decoction,Guizhi Gancao Longgu Muli Decoction and Ganmai Dazao Decoction as the main formulas,adjusted according to the symptoms.The article presents two cases:one diagnosed with spleen deficiency and dampness excess,treated by warming the middle and eliminating dampness;the other with heart Yang deficiency,treated by warming Yang and calming the spirit,both showing significant therapeutic effects.[ConclusionConclusion]Professor HUANG’s approach to treating cancer-related insomnia from the perspective of Yang deficiency,with careful differentiation of organs and consideration of both root and branch symptoms,has achieved remarkable results and is worth learning and applying in clinical practice.

关 键 词：癌因性失眠 不寐 阳不入阴 脾胃阳虚 心阳亏虚 脏腑辨证 医案 名医经验 

分 类 号：R395[哲学宗教—心理学]