仝小林运用黄连、肉桂、酸枣仁治疗心火亢盛失眠经验

Professor Tong Xiaolin’s experience in treating insomnia with golden thread,cassia bark and spine date seed

黄连、肉桂、酸枣仁,是临床常用治疗心火亢盛不寐的小方。仝小林院士认为,黄连入心经,长于清心火以安神,临床常用剂量为3~6 g;肉桂性大热,味辛、甘,补火助阳,引火归原,与黄连配伍,能交通心肾,使心火下降,肾水上升,水火既济,临床常用剂量为1~3 g;酸枣仁味酸,性敛,有助于"阳入阴",且使已入之阳不轻易外出故亦能防治早醒。临床常用剂量为15~60 g,可用至120 g。仝小林认为,心火亢盛之失眠症辨证要点为心烦失眠、夜尿多,溲黄舌红。盗汗加煅龙骨、煅牡蛎,肾水不足加生地,舌红少津加瓜蒌牡蛎散,失眠重加夜交藤、远志。治睡眠之药需注意服法,晚饭后服半剂,睡前服半剂。三味药组成治疗心火亢盛小方,既能针对"心火亢盛",基础实验表明其又具有明确的镇静助眠作用,在临床上应用效如桴鼓。

Golden thread,cassia bark and spine date seed are commonly used in a minor prescription by Professor Tong Xiaolin to treat insomnia due to exuberance of heart fire.According to Academician Tong Xiaolin,golden thread acts on heart channel and is good at clearing heart fire for tranquillization,with a usual dosage 3-6 g.Cassia bark,whose nature is extremely hot and taste is pungent and sweet,can tonify fire and strengthen yang,and induce fire back to its origin.When compatible with golden thread,it can link heart and kidney,making heart fire descend,kidney water ascend,and balance water and fire.Its clinical commonly used dosage is 1-3 g.Spine date seed,sour in taste and astringent in nature,is helpful for "yang entering yin" and can prevent entered yang from going out easily,so it can also prevent early awakening.The commonly used dosage is 15-60 g,and the maximum dosage can be up to 120 g.Professor Tong Xiaolin believes that the key points of syndrome differentiation of insomnia with exuberance of heart fire are upset,insomnia,nocturia,yellow urine and red tongue.When night sweating occurs,calcined dragon mulberry is to be added to the prescription.When kidney water is insufficient,unprocessed rehmannia root is to be added.When tongue is red and fluid lacks,Gualou Muli Powder is to be added.When insomnia gets severe,tuber fleeceflower stem and milkwort root are to be added.To achieve its best effect,half of the medicine should be taken after dinner and half before going to bed.The minor three-herb prescription,proved to have an instant clinical effect,can not only cope with exuberance of heart fire,but also have a specific sedative and sleep-inducing effect.