基于“脏腑别通”理论运用通腑调脏法治疗失眠

Treatment of Insomnia by the Method of Unblocking the Bowels and Harmonizing Viscera Based on the Theory of"Viscera-Bowels Extraordinary Connection"

阐释运用通腑调脏法治疗失眠的临证思路。以《医学入门》“脏腑别通”理论为基础,结合古代医家、现代学者之理论研究、临床实践及自身经验,认为腑气不通导致脏气失调是失眠的基本病机,临证常见胆腑痰热扰动心神、胃腑血瘀气滞阻塞心包、大肠浊热化火动肝、小肠湿邪困脾、膀胱水饮干肺、三焦原气不畅损肾等具体病机,并分别以温胆汤、桃核承气汤、承气汤类方、苓桂术甘汤、五苓散、小柴胡汤治之。

This paper aimed to explain the clinical thinking of using the method of unblocking the bowels and harmonizing viscera.Based on theory of"viscera-bowels extraordinary connection"of The Gateway to Medicine(《医学入门》),combined with the theoretical research,clinical practice and individual experience of ancient physicians,modern scholars,it is believed that viscera qi disorder caused by bowels qi blocking is the basic mechanism of insomnia.In clinic,it is common that gallbladder phlegm-heat harassing the heart spirit,stagnant blood and qi in stomach blocking the pericardium,turbid heat in large intestine causing fire and affecting liver,dampness insmall intestine trapping the spleen,water retention in the bladder drying up lungs,and the inhibited original qi of sanjiao damaging thekidney,which could be treated with Wendan Decoction(温胆汤),Taohe Chengqi Decoction(桃核承气汤),Chengqi-seriesDecoction(承气汤类方),LingguiZhugan Decoction(苓桂术甘汤),WulingPowder(五苓散),Xiaochaihu Decoction(小柴胡汤),respectively.