贾跃进老中医运用柴胡加龙骨牡蛎汤治疗不寐经验

Prof. Jia Yuejin's Experiences in the Treatment of Insomnia with Chaihu Jia Longgu Muli Tang

柴胡加龙骨牡蛎汤出自《伤寒论》,是由小柴胡汤去甘草加龙骨、牡蛎、桂枝、茯苓、铅丹、大黄而成。原方为张仲景治疗伤寒八九日,误用攻下之法,使病邪内陷、弥漫全身,形成表里俱病、虚实错杂而致少阳枢机不利的少阳病证。贾跃进老中医认为,睡眠障碍出现的睡中易醒、早醒、入睡困难时烦躁等均是肝胆郁滞、气机不畅、枢机不利的表现。此类患者虚实辨证不明显,既往身体健康,但情绪敏感。贾老认为调节人体气的运行,是治疗枢机不利型不寐的关键,而少阳是人体气机运行的重要环节,也是人体气机消长变化的纽带,气机内外沟通的通道。柴胡加龙骨牡蛎汤是调和枢机,和解少阳,宁心安神的典型方剂,故贾老运用柴胡加龙骨牡蛎汤治疗枢机不利型不寐,取得很好的临床疗效。

Chaihu jia longgu muli tang is from Treatise on Febrile Diseases,in which,liquorice is removed from xiaochihu tang,ossa draconis,oyster,cassia twig,poria,miniumite and rhubard are added. Zhang Zhongjing used the original in the treatment of febrile diseases and mis-used purgation method,leading to the deeper transmission of pathogens and resulting in the disorders of both the exterior and the interior,the mixture of the deficiency and the excess,and shaoyang disorder. Prof. Jia Yuejin thinks that sleeping disorder presents the manifestations of the stagnation of liver and gallbladder and disorder of qi activity,as easy waking-up and irritability. Generally,the deficiency and the excess are not apparently differentiated,the general physical condition is healthy and the emotion is sensitive. Prof. Jia thinks that regulating qi activity is the key of treatment. Shaoyang is the important link of qi activity in the human body,the consumption and growth of qi activity and the pathway of the internal and external flow of qi activity. Chaihu jia longgu muli tang is the classic formula for regulating qi activity,harmonizing shaoyang and tranquilizing the mind. Prof. Jia has applied chaihu jia longgu muli tang to the treatment of insomnia due to dysfunction of qi activity and the very good clinical efficacy is achieved.