《辨证录·不寐门》辨治探析

Analysis of Syndrome Differentiation and Treatment of Syndrome Differentiation Record·Insomnia

中医治疗不寐有明显优势。《辨证录·不寐门》中相关理论与实践颇具特色,且行之有效。经分析归纳可分为五大证型:心肾不交,肝郁血虚、肾水不足,胆气虚怯,肝血亏虚、邪火扰魂,胆虚风袭。总结病机方药阐述主要集中在心肾不交和肝胆之虚。并对组方进行了相应的频数和关联规则分析,得出方药主用白芍、当归补益肝胆,地黄滋补肾水,枣仁、远志入心经与胆经,益肝胆、宁心志、利九窍、安五脏,成为核心药物组合,在治疗不寐的方药中起到了关键作用。为今后对于失眠的中医病机认识和遣方用药提供了重要的指导和借鉴。

Traditional Chinese medicine(TCM)has obvious advantages in treating insomnia.The relevant theories and practices in Syndrome Differentiation Record·Insomnia are quite distinctive and effective.As revealed,insomnia can be divided into the following five syndromes:heart-kidney non-interaction syndrome,liver depression,blood deficiency,and kidney water insufficiency syndrome,gallbladder qi insufficiency with timidity syndrome,liver blood deficiency and evil fire disturbing the soul syndrome,and wind attacking due to gallbladder qi deficiency syndrome.As indicated by the analysis of pathogenesis and prescriptions,the main pathogenesis of insomnia is heart-kidney non-interaction and liver and gallbladder deficiency.As suggested by the frequency analysis and the association rule analysis of prescriptions,the prescriptions mainly consist of Paeoniae Radix Alba and Angelicae Sinensis Radix for replenishing the liver and gallbladder,Rehmanniae Radix for nourishing kidney water,and Ziziphi Spinosae Semen and Polygalae Radix for acting on heart and gallbladder meridians.Those drugs,effective in benefiting the liver and gallbladder,tranquilizing the mind,improving the nine orifices,and calming the five internal organs,serve as the core drug combination and play a key role in prescriptions against insomnia.The present study is expected to provide important references for the understanding of TCM pathogenesis and medication for insomnia in the future.