“肝藏血,血舍魂”与睡眠障碍辨治

Differentiation and Treatment of Sleep Disorder from "Liver blood and soul/肝藏血,血舍魂"

睡眠障碍古籍记载为失眠(不寐、不得眠、目不瞑)、失魂(离魂)等,指非疾病引起睡眠与觉醒量与质的变化;多由家庭、社会、人际关系等压力造成。神、魂、魄与生俱来,称之先天之神。《内经》记载魂由血舍、由肝藏,肝不藏血则血不舍魂,魂魄妄行,引发睡眠障碍。肝藏血,血舍魂,肝血魂正常,睡眠才能得到保障;肝血、肝阴不足及肝胆湿热,均影响肝藏魂。神有广义、狭义之别,与睡眠关系密切的主要指五神(神、魂、魄、意、志),即狭义之神。五脏对应五神,肝与魂相配,肝不藏血,血不舍魂,魂魄妄行则睡眠障碍。魂无所居则梦魇,阿胶、枣仁、枸杞、生地、熟地等养血滋阴之品,肝血得藏则不寐得治;魂失所藏易发梦遗;肝阴血不足则无以潜阳,风邪内动,肝血亏虚,魂游于外则夜惊,治以滋阴养血加镇静安神之品使肝血得养,卧则魂归而守。多卧治疗可选《赤水玄珠》"多卧醒睡汤"。多梦属肝血虚无以安魂定志,宜滋养肝阴,方选杞菊地黄汤。

Sleep disorders are recorded in ancient books as insomnia(sleepless, Budemian, Mubuming),loss of soul(soul wandering)etc, and refers to changes in the quantity and quality of sleep and awakening caused by non-disease;most of them are caused by stress from family, society, interpersonal relations, etc.Spirit, soul and Po are born to be called the innate spirit. The soul which is closely related to the liver and is one of the manifestations of the spirit. Neijing records the soul from the blood shedding and the liver storing,the liver does not store the blood, and the blood does not shed soul so that causes the sleep disorder."Liver storing blood, blood shed soul, liver blood soul is normal, sleep can be guaranteed;liver blood, liver Yin deficiency and liver and gallbladder damp-heat, all affect liver shed soul. Spirit closes relationship with sleep mainly refers to the five spirit(spirit, soul, Po, Yi, will), that is, the narrow sense of spirit. The five viscera correspond to the five spirit, the liver is matched with the soul, so the liver does not store the blood that the blood does not shed soul, the sleep will disorder. The soul has no place to live, and the blood-nourishing and Yin-nourishing products such as colla corii asini, fructus lycii, and radix rehmanniae Preparata can be used for nourishing blood and Yin. Sleep disorder would be cure under the liver storing blood. The loss of the soul is easy to cause nocturnal emission, Liver Yin blood deficiency does not restrict Yang, wind-evil internal movement, liver blood deficiency, soul wandering will be night terror, treatment to nourish Yin and blood plus sedative and tranquil products so that the liver blood is nourished, soul will return when we sleep. Multi-lying treatment can select "Duowo Xingshui decoction" of Chishui Xuanzhu. Multi-dreams belong to the liver blood deficiency to calm down the spirit, should nourish liver Yin, and select Qiju Dihuang decoction.