基于《素问·灵兰秘典论》“心神使道论”探讨失眠治疗思路

Discussion on the treatment of insomnia based on“the theory of the heart and the spirit make the way”of Suwen·Linglan’s Secret

《黄帝内经》中神志学说在睡眠中的地位和作用,不可忽视,《素问·灵兰秘典论》论述了“心神使道论”,对失眠的诊疗具有重要的指导作用。本文指出失眠的基本病机为心神出而不入,阳动而不静,治疗失眠的原则应当使阳入阴,心神动而能静。睡眠的发生,首先需要,心君功能正常,方能“心主神明”;同时使道必须通畅,才能把君主的正确旨令传达于五脏六腑、四肢百骸等各器官。故神气安宁和使道通畅是睡眠产生的重要条件,如果两者其一功能异常就会导致失眠的发生。理清这一点,有利于指导为现今学者及临床工作者研究和诊治失眠提供新的思路。

The place and role of the theory of shenzhi in sleep in the Huangdi Neijing,which cannot be ignored.Suwen·Linglan’s Secret discusses“the theory of the heart and the spirit make the way”,which is an important guide to the diagnosis and treatment of insomnia.Therefore,this paper points out that the basic pathogenesis of insomnia is that the mind is out but not in,and the yang is moving but not quiet,and the principle of treating insomnia should be to make the yang of the mind enter into the yin,and the mind is moving but can be quiet.The occurrence of sleep,first of all,the heart needs to function normally,and“the heart is the master of God”;at the same time,the channel must be smooth,in order to convey the correct orders of the monarch to the organs of the five zang viscera,six fu viscera,limbs and bones,and other organs.Therefore,the tranquillity of the divine energy and the smoothness of the path are important conditions for the production of sleep,and if one of them functions abnormally,it will lead to insomnia.Sorting this out will help guide new ideas for today’s scholars and clinicians in the study and diagnosis of insomnia.