从阴阳平衡论失眠

Discussion About Insomnia from Balance of Yin and Yang

正常的睡眠与阴阳的升降平衡有直接关系,阴阳升降出入正常,则人体可正常寐寤。阴阳升降平衡失常,则发为失眠。若阳偏亢,不能正常下潜入于阴,则发为失眠,多表现为入睡困难,可用栀子豉汤或酸枣仁汤加减,以滋阴清热,清心除烦,亦可依据不同病因采用龙胆泻肝汤加减、交泰丸加减、百合地黄汤加减等治疗。阳扰于阴,表现为入睡容易,但是多梦、易醒,此类失眠与三焦、肝、胆、胃关系密切,可采用保和丸或温胆汤加减治疗,如属血瘀证可选用血府逐瘀汤加减治疗,属心肝血虚证者可采用安神定志汤、逍遥丸或归脾汤等治疗。阳早出于阴,表现为入睡不难,但睡眠持续时间不长、醒后不易再入睡、早醒,此类失眠和三焦、胆、肺、大肠等关系密切,患者多为老年人或抑郁症患者。老年人失眠,可采用老人不寐丸、左归饮、桂枝龙骨牡蛎汤等加减治疗。抑郁症患者,可采用柴胡加桂枝龙骨牡蛎汤、柴桂温胆定志汤等治疗。治疗时要综合分析,找准病机,平衡阴阳,调畅气机,方能显效。同时,要适当调整作息时间,顺应阴阳变化,养阴养阳,使人体处于阴阳相对平衡的状态,则失眠自愈。

Normal sleep is directly related to the ascending and descending balance of yin and yang.If the ascending and descending of yin and yang are normal,the human body can sleep normally.If the ascending and descending of yin and yang are abnormal,insomnia will occur.If yang is hyperactive and can′t dive into yin normally,it will cause insomnia,which is mostly manifested as difficulty in falling asleep.Modified Decoction of Fructus Gardeniae and Semen Sojae Preparatum or Sour Jujube Decoction can be used to nourish yin and clear heart heat and remove annoyance.It can also be treated by Modified Gentian Liver-Draining Decoction,Modified Jiaotai Pill(交泰丸加减,MJTP),Modified Lily Bulb Rehmannia Decoction according to different etiology.If yang interferes with yin,the patient will be easy to fall asleep,but dreamy and easy to wake up.This kind of insomnia is closely related to triple energizer,the liver,gall and stomach,which can be treated with Harmony-Preserving Pill,or Modified Gallbladder-Warming Decoction.For blood stasis syndrome,it can be treated with Blood Mansion Stasis-Expelling Decoction.For heart-liver blood deficiency syndrome,it can be treated with Spirit-Tranquilizing Mind-Stabilizing Decoction,Free Wanderer Pill,Spleen-Restoring Decoction,etc.If yang comes out of yin early,the patient will be not difficult to fall asleep,but the sleep duration will not be long,and it will be not easy for the patient to fall asleep again,but easy to wake up early.This kind of insomnia is closely related to triple energizer,the gall bladder,lung,large intestine and so on.Most of the patients are the elderly or the depressed.For the elderly with insomnia,Insomnia Pill,Left-Restoring Beverage,Modified Cinnamon Twig and Os Draconis and Oyster Shell Decoction can be used.For the patients with depression,Bupleurum Decoction plus Cinnamon Twig and Os Draconis and Oyster Shell,Bupleurum and Cinnamon Twig Gallbladder-Warming and Mind-Stabilizing Decoction,etc.can be used.When treating,doctors should analyze many factors comprehensively,and find out the pathogenesis accurately in order to balance yin and yang,and regulate qi movement to achieve good effects.At the same time,the patient should adjust the work and rest time appropriately,adapt to the changes of yin and yang,nourish yin and yang in order to make the human body in a state of relative balance of yin and yang,then insomnia will be healed naturally.