张凤武主任从脾胃论治失眠经验总结

Director ZHANG Fengwu’s experience in treating insomnia from the aspect of spleen and stomach

失眠是指经常不能获得正常睡眠的症状。失眠多因思虑劳神太过、气血亏虚,或因情志所伤、气机不舒等,使阴阳不和、神气不宁所致。其常见于不寐、神劳、癫痫病、狂病等脑系统疾病,亦可因其他全身疾病引起。西医治疗失眠多采用心理治疗、药物治疗、物理治疗,但药物疗法大多有镇静作用,长时间服用会出现乏力、头昏等不良反应,进而产生依赖性及戒断反应,对于部分患者仅可缓解临床症状而不能根治该病,长期疗效不佳。中医治疗讲究辨证论治、治病求本,一人一方的个性化诊疗方案能针对不同病因对症用药,有效降低复发率。中医疗法不良反应小,作用显著,患者依从性高,对治疗本病有明显优势。失眠的病因病机错综复杂,宁夏回族自治区中医医院张凤武主任认为其与脾胃联系最为密切。表面看来不寐与心神失养联系最为密切,但其根本为脾胃失衡不能濡养五脏,致五脏功能失调最终影响心神,从而引发不寐。文章结合案例,介绍张凤武主任治疗失眠经验,以期为临床提供参考。

Insomnia refers to the symptom of often unable to get normal sleep.Insomnia is often caused by the disharmony of Yin(阴)and Yang(阳)and restlessness of spirit due to excessive thinking,deficiency of Qi(气)and blood,emotional injury,and maladjustment of Qi movement.It is common in patients with sleepless,mental fatigue,epilepsy,mania and other brain system diseases,and can also be caused by other systemic diseases.Western medicine mostly adopts psychotherapy,drug treatment,and physical therapy to treat insomnia.However,most of the drug therapies have sedative effects.Taking these drugs for a long time,patients will have adverse reactions such as fatigue and dizziness,and then have dependency and withdrawal reactions.For some patients,only clinical symptoms can be relieved,but the disease can not be cured.The long-term effect is poor.TCM emphasizes the treatment based on syndrome differentiation and treating diseases from the root causes.The personalized diagnosis and treatment plan can be used symptomatically for different causes,effectively reducing the recurrence rate of the diseases.TCM has obvious advantages in treating this disease due to its small adverse reactions,significant effects,and high compliance of patients.The etiology and pathogenesis of insomnia are complex.Director ZHANG Fengwu from Traditional Chinese Medicine Hospital of Ningxia Hui Autonomous Region believes that insomnia is most closely related to the spleen and stomach.On the surface,insomnia is most closely related to unnourished mind,but its fundamental reason is that the imbalance of the spleen and stomach cannot nourish the five viscera,resulting in the dysfunction of the five viscera,which ultimately affects the state of mind and causes insomnia.This article introduces the experience of Director ZHANG Fengwu in treating insomnia with a case study in order to provide a reference for clinical practice.