基于卫气“从阴绕行出阳”模式探讨餐后嗜睡的病机及临证应用  

Mechanism of Postprandial Drowsiness and the Clinical Application under the Model of Wei Qi Circulating from Yin to Yang

作　　者：康鹏飞 孙伯菊 王聪慧 陈香美 KANG Pengfei;SUN Boju;WANG Conghui;CHEN Xiangmei(Department of Nephrology,First Medical Center of Chinese PLA General Hospital/National Key Laboratory of Kidney Diseases,Beijing,100141;Fengtai District Traditional Chinese Medicine Hospital,Beijing)

机构地区：[1]中国人民解放军总医院第一医学中心肾脏病医学部/肾脏疾病全国重点实验室,北京市100141 [2]北京市丰台区中医医院

出　　处：《中医杂志》2025年第8期769-774,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(32141005)。

摘　　要：餐后嗜睡是以餐后出现显著睡意为特征的病症,《黄帝内经》认为其与卫气相关。通过梳理《黄帝内经》原文及后世医家观点,发现寤寐转换依赖卫气的“阴阳相引”,且卫气出入的两条路径在脾胃有交会。据此认为餐后嗜睡的核心病机是上焦闭塞或脾胃失常致卫气滞留于内,阴阳相引,使体表卫气内陷引发嗜睡;此时滞留卫气与内陷卫气在脾胃交汇,并入脏腑循环,改道足太阳而出,形成“从阴绕行出阳”的运行模式。治疗需标本兼顾,以调节卫气流转趋向为标;助卫气从阴出阳以恢复寤寐节律为本。通过提出卫气从阴绕行出阳模式,为餐后嗜睡的理解提供新视角。Postprandial drowsiness is a clinical condition characterized by pronounced drowsiness after meals,while The Inner Canon of Yellow Emperor(《黄帝内经》)associates this condition with wei qi(defensive qi).By analyzing the original texts of The Inner Canon of Yellow Emperor and perspectives from many medical professionals,it is found that the transition between wakefulness and sleep depends on the mutual induction of yin and yang,and that the two pathways of wei qi circulation intersect at the spleen and stomach.Based on this,the core pathogenesis of postprandial drowsiness is proposed to be either upper jiao obstruction or spleen-stomach dysfunction,leading to the stagnation of wei qi internally,then the mutual induction of yin and yang causes inward invasion of wei qi in the body,resulting in drowsiness;at this stage,the stagnated and inward invasive wei qi converges at the spleen and stomach,then merges into the circulation of zang-fu organs,rerouting through the Foot Taiyang Meridian,forming a circulation pattern described as"circulating from yin to yang".Treatment should focus on the root and branch simultaneously,with the primary goal of regulating the circulation of wei qi;facilitating its transition from yin to yang to restore the sleep-wake cycle.By proposing the model of wei qi circulating from yin to yang,this study offers novel insights on the understanding of postprandial drowsiness.

关 键 词：餐后嗜睡 卫气 阴阳相引 《黄帝内经》 

分 类 号：R256.23[医药卫生—中医内科学]