黄元御基于“一气周流”理论治疗痰火扰心型不寐的经验

Huang Yuanyu’s experience in treating insomnia with phlegm-fire disturbing heart type based on the theory of “cycle flow of one qi”

不寐,是由于情志、饮食内伤等诸多病因,导致经常不能获得正常睡眠的一类病证,其中痰火扰心证在临床颇为常见。清代医家黄元御秉持“一气周流”思想,从中土之气为基转枢纽,调动木、火、金、水四象升降之气的角度出发,以探析本病的病因、病机、证治法则。他认为中土衰败,痰浊蕴蒙,相火生发,是痰火扰心型不寐的基本病机,据此形成特色显著的治疗大法,即培土制水,静火祛浊。在治疗过程中,多以黄芽汤、金鼎汤为基础加减应用,以求振奋中土,畅调升降,达到痰火不生,寤寐有序的目的。

Insomnia,is due to emotion,diet,internal injury,and many other causes,often can not get normal sleep as a kind of disease syndrome,of which phlegm-fire disturbing heart type is quite common in clinical.Huang Yuanyu,a doctor in the Qing Dynasty,held the idea of“cycle flow of one qi”,from the point of view of qi of spleen and stomach as the basis hub to transfer the other four of the five elements,names wood,fire,gold,and water,to explore the etiology,pathogenesis,syndrome,and treatment of the disease.He believes that the basic pathogenesis of insomnia with phlegm-fire disturbing heart type is the decay of spleen and stomach,phlegm-turbidity disturbing clear orifices,and ministerial fire growth.Based on this,a distinctive treatment method is formed,that is banking up earth to control water,diving ministerial fire and eliminating phlegm-turbidity.In the course of treatment,the application of Huangya Decoction and Jinding Decoction is mostly based on addition and subtraction,in order to the spleen and stomach and make the movement of qi rise and fall harmoniously,to achieve the purpose of phlegm fire not produce and sleep orderly.