国医大师熊继柏从痰热论治失眠症临证经验

Experience Examples of National TCM Master Xiong Ji-bai for the Treatment of Insomnia Caused by Phlegm-heat Internal Disturbance

历代医家对失眠症认识虽有不同,但总以阴阳失调、脏腑失衡为主要病机。国医大师熊继柏认为,本病总以痰热内扰为核心病机,临证多从痰论之,强调痰、湿、热在疾病发生、发展及治疗中的关键作用。由于现代人生活节奏快,长时间心情紧张,易致肝气郁结,思虑气结,久郁而伤心脾,脾虚湿蕴,聚而生痰,郁而化热;或因过食肥甘厚味,导致体内痰湿内生,久积则化热,故痰、湿、热郁结,扰心动神而导致失眠。熊老以黄连温胆汤随症加减,取得满意疗效。

Although the understanding of insomnia varies among medical experts in different dynasties,they generally explain it as the main pathogenesis of yin-yang imbalance and organ dysfunction.National master Xiong Jibai believes that phlegm-heat internal disturbance is the core pathogenesis of this disease,and clinical treatment is often conducted from phlegm,and he emphasizes the crucial role of phlegm,dampness,and heat in the onset,development,and treatment of the disease.Due to the fast-paced life,and prolonged mental tension,liver qi stagnation,qi stagnation caused by excessive thinking,and long-term stagnation can damage the heart and spleen,leading to spleen deficiency and dampness accumulation,resulting in phlegm accumulation and heat transformation.Alternatively,people’s disregard for light and bland diets and their preference for fatty,sweet,and strong-tasting foods can lead to the internal generation of phlegm and dampness,which can accumulate and transform into heat.Therefore,it is easy for phlegm,dampness,and heat to accumulate and disturb the heart and spirit,leading to insomnia.Xiong Jibai uses Huanglian Wendan Decoction with symptom-based modifications and achieves satisfactory therapeutic effects.