失眠合并老年轻度认知障碍从肝郁肾虚论治

Insomnia Combined with Mild Cognitive Impairment in Elderly Should be Treated from Liver Depression and Kidney Deficiency

失眠是临床上最为多见的睡眠障碍类型,多指患者对睡眠时间、质量不满足而影响了日常生活功能的一种主观体验。随着失眠病程的进展,常伴随一系列并发症,临床尤以老年轻度认知障碍(MCI)最常见。失眠在祖国医学中又称为不寐,老年轻度认知障碍称为健忘。失眠初期往往都会出现一系列主观行为异常(比如心情低落、不爱言谈、喜静懒动等;或者性情焦躁、烦躁不安、性格大变等),需积极干预早期行为异常问题,同时加强患者的自我认识,防治失眠的发生及进展恶化。而目前临床上的失眠患者大多都病程较长,且都伴有不同的并发症,研究将针对失眠并老年MCI进行探讨,讨论二者中西医发病机制的相关性,中医强调以人为核心,精准辨别病性及病位,寻求致病的病因病机,重点从中医调理肝、肾功能来论治该病,以开拓临床治疗思维。

Insomnia is the most common type of sleep disorder in clinical practice. It refers to the subjective experience of patients with inadequate sleep time and quality that affects their daily life function. With the development of insomnia,it is often accompanied by a series of complications,especially mild cognitive impairment (MCI) in the elderly. Insomnia in the motherland medicine is also called insomnia and the elderly mild cognitive impairment is called forgetfulness. Insomnia in the early stage will often appear a series of subjective behavior abnormalities (such as feeling upset,do not like to talk,like static lazy movement,or anxiety,restlessness,personality changes,etc.),it is necessary to actively intervene in the early abnormal behavior,strengthen the patient ’s self-knowledge,prevent the occurrence and progression of insomnia. Now most patients have a longer durationand are accompanied by different complications. This reviewfocused on the elderly insomnia patients with MCI and analyzed the pathogenesis relationship between Chinese and Western medicine. TCM takes the body as the center and makes the accurate differentiation of the nature and location of the disease. The treatment of TCM is focus on regulating liver and kidney so as to widen the clinical thinking.