从脾郁气结论治焦虑失眠症的思路探讨

Exploration of the Thoughts for Treating Anxiety-induced Insomnia from the Perspective of Spleen Depression and Qi Stagnation

过度的精神压力可导致焦虑,而焦虑又可致失眠的发生。基于中医思虑伤脾理论,认为过思伤脾而气结可致焦虑失眠症,“脾郁气结”为其核心病机,“建中运脾”为焦虑失眠症的关键治法,基于小建中汤加减而成的建中解郁方(主要由桂枝、白芍、山药、黄精、炙甘草、生姜、大枣等组成)为治疗焦虑失眠症的基础方,临证时可根据所累及的脏腑加减用药。基于中医思虑伤脾理论从脾郁气结论治焦虑失眠症可为其临床辨治提供新思路。

Excessive mental stress can lead to anxiety,which in turn can cause insomnia.Based on the theory of anxiety hurting the spleen in the field of traditional Chinese medicine,it is believed that over-thinking hurts the spleen and causes qi stagnation,which may lead to anxiety-induced insomnia.Spleen depression and qi stagnation contribute to the core pathogenesis of anxiety-induced insomnia,and therapy of fortifying middle energizer and activating spleen can be used as the key method for the treatment of anxiety-induced insomnia.And Jianzhong Jieyu Prescription(mainly composed of Cinnamomi Ramulus,Paeoniae Radix Alba,Dioscoreae Rhizoma,Polygonati Rhizoma,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Zingiberis Rhizoma Recens,and Jujubae Fructus,etc.),which is derived from Xiao Jianzhong Decoction,can be used as the basic formula for treating anxiety-induced insomnia.The prescription can be used by modification in clinic according to the viscera involved.The treatment of anxiety-induced insomnia from the perspective of spleen depression and qi stagnation based on the theory of anxiety hurting the spleen in TCM can provide new ideas for its clinical management.