急性心肌梗死后失眠辨治临床经验

Experience on Syndrome Differentiation and Treatment for Insomnia after Acute Myocardial Infarction

急性心肌梗死后失眠是临床常见问题,常使原发性心脏疾病反复发作甚至加重。田相同运用桂枝加龙骨牡蛎汤加减治疗急性心梗后失眠,临床收到显著疗效。田老师认为,在真心痛发病基础上并发的不寐,病机以心阳虚为根本,复感邪气内扰,致营卫不和、阴阳失交,故从温心阳入手,以调营卫、潜心安神为治则,并对证酌情加减药物补虚泻实,从而达到对急性心肌梗死后失眠的标本兼治,临床取得显著疗效。

Insomnia after acute myocardial infarction is common in clinic,and it often cause reoccurrence of primary heart disease and even worsen it. Professor TIAN Xiangtong uses Guizhi Jia Longgu Mull decoction to treat insomnia after acute myocardial infarction,and the effect is satisfactory. According to Professor Tian Xiangtong,the underlying cause of the insomnia after acute myocardial infarction is the deficiency of heart yang,and the invasion of evil qi leads to disharmony between nutrient qi and defensive qi,with incompatibility between yin and yang. Therefore ,the therapeutic principle is to warm heart yang to harmonize nutrient qi and defensive qi,and to calm the heart and mind. The formulas are often modified based on the syndrome to tonify the deficiency and purge the excess ,and therefore insomnia after acute myocardial infarction can be treated for the root and branch with satisfactory effect.