徐志伟教授治疗不寐的经验撷菁

Clinical experience of professor XU Zhi-wei in treating insomnia

文章从病因病机、辨证思路、治法方药和临证碎金等方面介绍了徐志伟教授诊疗不寐的经验。辨治失眠时,针对"阳盛阴衰,阴阳失交"这一失眠的总病机,徐教授强调病证结合、首辨虚实、详审兼症,若属虚烦不寐方用酸枣仁汤,痰湿不寐方用温胆汤,肝郁不寐方用四逆散,阴阳失和不寐方用桂枝加龙骨牡蛎汤。同时,徐老师重视地域因素、服药时间、心理因素和安神药的合理使用,临证取得了确切疗效。文末介绍典型医案一则,希冀反映其对不寐的认识和诊疗特色。

In this article,the pathogenesis,thinking of syndrome differentiation,treatment and prescriptions,three supplements were introduced to describe the clinical experience of professor XU Zhi-wei in treating insomnia.When diagnosing and treating,the TCM pathogenesis of insomnia,which is about disharmony of yin and yang should be aimed at.Professor XU emphasizes combining disease and syndrome,firstly distinguishing the deficiency and excess,differentiating and analyzing accompanied symptom.If it is liver-blood deficiency result insomnia with weakness and irritability,the patients could be given Suanzaoren Decoction.If it is syndrome of stagnated gallbladder qi with disturbing phlegm,the patients could be given Wendan Decoction.If it is liver depression and qi stagnation,the patients could be given Sinisan Decoction.If it is disharmony of yin and yang,the patients could be given Guizhijialonggumuli Decoction.Meanwhile,professor XU indicates regional factor,medication schedule,mental factors and intelligent use tranquilizer of Chinese medicine also should be considered.For responding to diaqnosinq and treating features of professor XU＇s,at the end of this article,a typical medical case is introduced.