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从肝论治失眠

Treating insomnia from the perspective of liver
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摘要 失眠是临床常见的睡眠障碍性疾病,会导致患者注意力下降、抑郁、焦虑等神经心理异常,而此类神经心理异常又会反过来加重失眠,形成恶性循环,影响人们的日常生活。随着经济发展和现代社会生活节奏加快,该病的年发病率呈上升趋势,值得关注。中医学认为,百病生于气,气郁影响肝的疏泄功能,导致气血津液的布散失常,形成痰阻、食积、瘀血等病理产物,导致神魂失养,进而引发失眠。若失眠经久不愈,肝郁会愈加严重,导致病情缠绵难愈。李润东教授临床观察发现失眠的病因病机多为肝郁,主张以疏肝解郁为主要治则,在此基础上辨证论治。李润东教授以中医脏腑理论为指导,结合多年的临床经验,认为治疗失眠当从肝入手,兼顾他脏,并注重对患者进行心理疏导和精神调摄,叮嘱患者进行适度的锻炼,创造良好的睡眠环境,定时就寝,以养成良好的睡眠习惯。治疗时,李润东教授擅长运用药对,充分发挥药物的相互作用,提高了临床疗效。文章从肝的生理功能出发,从肝主疏泄,肝藏血、血舍魂,肝开窍于目三个方面阐述肝与睡眠的关系,以治肝为中心,兼顾调理其他四脏,以求阴平阳秘。心静神自安,则失眠可愈。 Insomnia is a common clinical sleep disorder,which can lead to patients’attention loss,depression,anxiety and other neuropsychological abnormalities,and this kind of neuropsychological abnormalities in turn aggravate insomnia,forming a vicious circle,affects people’s daily life.With the economic development and the accelerated pace of modern social life,the annual incidence rate of the disease shows an upward trend,which is worthy of attention.TCM believes that all diseases are born in Qi(气),Qi stagnationI affects the drainage function of the liver,resulting in the distribution disorder of Qi,blood and body fluid,and the formation of phlegm obstruction,food accumulation,blood stasis and other pathological products,leading to the loss of spirit,and causing insomnia.If insomnia does not heal for a long time,liver stagnation will become more serious,resulting in recurring illness.Professor LI Rundong has found that the main cause and pathogenesis of insomnia were liver stagnation,and advocated that soothing the liver and resolving stagnation should be the main treatment principle,with syndrome differentiation as the basis.Professor LI Rundong,guided by the Zang-fu organs(脏腑)theory of TCM and combined with many years of clinical experience,believes that the treatment of insomnia should start from the liver,take into account other internal organs,and pay attention to the psychological counseling and mental regulation of patients.Patients are told to take moderate exercise,create a good sleep environment,and go to bed regularly to develop good sleep habits.In the treatment,Professor LI Rundong is good at using paired medicine to give full play to the interaction of medicines,and the clinical efficacy is improved.Starting from the physiological function of the liver,this paper expounds the relationship between the liver and sleep from the following three aspects:the liver plays a key role in dispersing function,the liver holds the blood and the blood holds the soul,and ocular diseases are closely related to the liver.Treating disease from the aspect of liver is the center of the treatment,taking into account the conditioning of the other four Zang-fu organs,so as to achieve balance of Yin(阴)and Yang(阳).When the mind is quiet,the insomnia will be cured naturally.
作者 王雯倩 李润东 WANG Wenqian
出处 《中医临床研究》 2023年第35期25-28,共4页 Clinical Journal Of Chinese Medicine
基金 山东省名老中医药专家传承工作室建设项目(鲁卫函[2019]92号) 鲁南吕氏肝病学术流派传承工作室建设项目(鲁卫函[2022]93号)。
关键词 失眠 从肝论治 疏肝解郁 药对 名医经验 Insomnia Treating disease from the aspect of liver Soothing liver and relieving stagnation Paired medicines Clinical experience of famous doctor
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