从“木郁达之”论治焦虑性失眠

Treatment of anxiety insomnia from the perspective of“facilitating the wood stagnation”

焦虑性失眠归属于中医“不寐”“惊悸”范畴,其病机为“木郁”所致三阴三阳枢机不利,阴阳失衡。初病在气,因气机失调,五脏升降失常,气血逆乱而见不寐。久病入络,营血瘀滞;脏腑气机不调,营血瘀滞不解,则营卫无所化生,由实转虚,遂成本虚标实之不寐证。“达之”以斡旋厥阴少阳枢机,转运三阴三阳为大法,初期开达气机,调和脏腑,久病入于营血,以化瘀养血,调和营卫。枢机得利,阴阳相交,气机调畅,营卫和合,则不寐可愈。附验案1则。

Anxiety insomnia belongs to the category of“insomnia”and“palpitation”in traditional Chinese medicine,and its pathogenesis is the three yin and three yang axis adverse,yin and yang imbalance caused by“Muyu”.The initial illness is in the qi,due to the imbalance of the qi mechanism,the abnormal rise and fall of the five internal organs,and the disorder of the qi and blood,resulting in insomnia.Long-term illnesses enter the collaterals,stagnation of blood stasis;if the qi of the viscera is not adjusted,and the stagnation of blood stasis is not resolved,then there is no metamorphosis of ying and wei,and deficiency transformed from excess and then led to insomnia syndrome with deficiency in origin and excess in superficiality.“Dazhi”takes mediating Jueyin and Shaoyang cardinal mechanism and transferring three yin and three yang as the great method.At the initial stage,it opens up the qi mechanism,harmonizes the viscera,and enters the ying blood after a long illness,so as to remove blood stasis and nourish blood and harmonize the ying and wei.If the cardinal mechanism is beneficial,yin and yang intersect,qi mechanism is smooth,and ying and wei are harmonious,insomnia syndrome can be healed.Following with one case.