冠心病合并失眠的病机与治疗概况

Analysis on Pathogenesis and Treatment of Coronary Heart Disease Complicated with Insomnia

通过对冠心病、失眠及两者合病病机的中西医两方面探讨,加深对冠心病合并失眠病机的认识,认为冠心病合并失眠的病机在中医方面主要表现为心主血脉与心主神明两大生理功能相互影响,在此基础上痰、瘀、火、虚兼夹为患。在西医方面认为两者合病与内皮功能障碍、交感神经张力增高、迷走神经张力减低及褪黑素水平下降等方面相关;治疗方面中医多为中药辨证治疗、中成药治疗或联合针灸、耳穴压籽等物理疗法,其中中药辨证论治以活血安神法研究最多,疗效也更为显著。西医学多将两病分而治之,西药叠加治疗或联合CBT(认知行为疗法)等疗法。文章从中西医两方面阐释冠心病与失眠的相关性,总结目前中西医治疗冠心病合并失眠的治疗概况,分析治疗方案的共性与差异,探求更佳治疗方案。

Through the discussion of coronary heart disease,insomnia and their combined pathogenesis in traditional Chinese and Western medicine,we deepen the understanding of the pathogenesis of coronary heart disease combined with insomnia.It is considered that the pathogenesis of coronary heart disease combined with insomnia in traditional Chinese medicine is mainly manifested in the interaction of two physiological functions of heart governing blood vessels and heart governing spirit.On this basis,phlegm,blood stasis,fire and deficiency are mixed.In western medicine,it is considered that the combination of the two diseases is related to endothelial dysfunction,increased sympathetic tension,decreased vagal tension and decreased melatonin level.In terms of treatment,traditional Chinese medicine is mostly traditional Chinese medicine syndrome differentiation treatment,traditional Chinese patent medicine treatment or combined acupuncture,ear acupoint seed pressing and other physical therapies.Among them,the method of promoting blood circulation and calming nerves is mostly studied,and the curative effect is more significant.Western medicine mostly treats the two diseases separately,including western medicine superposition therapy or combined CBT(cognitive behavioral therapy).This paper explained the correlation between coronary heart disease and insomnia from two aspects of traditional Chinese and Western medicine,summarized the current treatment of coronary heart disease combined with insomnia,analyzed the similarities and differences of treatment schemes,and explored better treatment schemes.