陆拯分亚型论治失眠经验介绍

Introduction to LU Zheng's Experience in Treating Insomnia by Subtyping

介绍陆拯教授分亚型论治失眠的临床经验。陆拯教授认为失眠因临床表现不同可分为入睡困难、嗜睡、多梦和易醒等四种亚型,各亚型亦当辨证论治。入睡困难主要有心脾两虚、心肾不交、肝火扰心、痰食阻胃证型,相应有补益心脾、交通心肾、清肝宁心、消食祛痰之法;嗜睡主要有湿邪困脾、中气不足、阳气虚弱证型,相应有燥湿健脾、补气健脾、温阳益气之法;多梦主要有肝火扰心、心胆气虚、心脾血虚、心肺气虚、肾不济心证型,相应有清肝安神、补心宁胆、补益心脾、补益心肺、补肾宁心之法;易醒主要有心肝血虚、心胆气虚证型,相应有滋肝宁心安神、补心宁胆定惊之法。陆拯教授还善于运用龙骨-牡蛎、化橘红-天南星、灵芝-琥珀、茯神-远志等药对,或潜阳镇心宁神、或化痰宁心安神、或益脑镇惊安神、或祛痰利水安神,以获良效。

Professor LU Zheng's clinical experience in treating insomnia by subtypes is introduced.Professor LU Zheng believes that insomnia can be divided into four subtypes due to different clinical manifestations:difficulty in falling asleep,drowsiness,excessive dreaming,and easy awakening.Each subtype should also be treated based on syndrome differentiation.The syndrome types of difficulty in falling asleep mainly includes deficiency of both the heart and spleen,non-interaction between the heart and the kidney,liver-fire harassing the heart,and phlegm and food obstructing the stomach,and the corresponding methods are supplementing and boosting the heart and spleen,restoring interaction between the heart and the kidney,clearing the liver and calming the heart,and promoting digestion and dissolving phlegm.The syndrome types of drowsiness mainly includes pathogenic dampness encumbering the spleen,center qi deficiency,and yang qi weakness,and the corresponding methods are drying dampness and fortifying the spleen,supplementing qi and fortifying the spleen,and warming yang and boosting qi.The syndrome types of excessive dreaming include liver-fire harassing the heart,heart-gallbladder qi deficiency,heart-spleen blood deficiency,heart-lung qi deficiency,and kidney discordance to heart,and the corresponding methods are clearing liver heat and calming the mind,tonifying the heart and calming the gallbladder,supplementing and boosting the heart and spleen,supplementing and boosting the heart and lung,and nourishing the kidney and calming the heart.The syndrome types of easy awakening include heart-liver blood deficiency,and heart-gallbladder qi deficiency,with corresponding methods being enriching the liver and calming the heart and the mind,and supplementing the heart,calming the gallbladder and arresting convulsion.Professor LU Zheng is also adept at using couplet medicines such as Os Draconis-Ostreae Concha,Citri Grandis Exdarpium-Arisaematis Rhizoma,Ganoderma-Succinum,Sclerotium Poriae Pararadicis-Polygalae Radix,to achieve good results,such as subduing yang,tranquilizing the heart and calming the mind,or dissolving phlegm and calming the heart and mind,or boosting brain,suppressing fright and calm the mind,or dissolving phlegm,promoting urination and calming the mind.