基于阴阳体用关系试述针灸治疗抑郁失眠共病的临床思路

Clinical Thinking of Acupuncture and Moxibustion in Treating Depression Combined with Insomnia Based on Essence-function Relationship between Yin and Yang

以阴阳体用关系为理论指导,认为阴阳的升降运动是升已而降,降已而升的一气周流圆运动,若阳气升不利,其降亦不利,降不利,其升亦随之受影响,而抑郁的产生是由于阳气升发不利所致,失眠的产生是由阳气下降潜藏失常所引起,其一气周流圆运动失常,阳气偏离其本位,内阳外阴的本病结构被打破故形成共病。治疗上主张以三焦为通路,综合运用针刺、刺络放血、麦粒灸疗法,通过清上焦、运中焦、补下焦的方式恢复阳气正常的升降运用和内阳外阴的本体结构则病愈。

According to the essence-function relationship between yin and yang,we believe that the ascending and descending of yin and yang are the circulation of qi.The unsmooth ascending of yang qi will lead to the unsmooth descending,which will further affect the ascending.Depression is caused by the unsmooth ascending of yang qi,and insomnia by the abnormal descending and storing of yang qi.Once the qi circulation is disordered and yang qi deviates from its original position,the essence structure of internal yang and external yin is disturbed and thus comorbidities are formed.Comorbidities can be treated from triple energizer by combining acupuncture,bloodletting by collateral pricking,and moxibustion with seed-sized moxa cone.The normal ascending and descending of yang qi and the essence structure of internal yang and external yin can be restored by clearing the upper energizer,regulating the middle energizer,and tonifying the lower energizer.