从“少阳为枢”学说探析柴胡加龙骨牡蛎汤治疗稳定型心绞痛合并失眠的论治思路

Application of Chaihu Longgu Muli Decoction in Treatment of Stable Angina Pectoris with Insomnia Based on Theory of Lesser Yang Being the Pivot

稳定型心绞痛合并失眠是临床常见双心疾病,主要临床表现为胸闷胸痛伴睡眠障碍。少阳为气机升降出入之枢、津液相火输布之枢、阴阳表里出入之枢。少阳枢机不利导致的气机升降失常、津液输布失常、相火妄动不安、阴阳出入失常是引起稳定型心绞痛合并失眠的重要病机。和解少阳枢机是治疗稳定型心绞痛合并失眠的重要方法,柴胡加龙骨牡蛎汤是其代表方剂。通过验案举例说明和解少阳可使枢机开阖有度,气机升降、津液相火输布有序,从而达到心血畅通、心神安宁。

Stable angina pectoris combined with insomnia is a common cardiovascular combined with psychological disease in clinical practice,with the main clinical manifestations of chest tightness,chest pain,and sleep disorders.Lesser yang is the pivot for the movement of qi,the transportation and distribution of body fluid and ministerial fire,and the exiting or entering of yin and yang from or into the body surface.The vital pathogenesis of stable angina pectoris combined with insomnia lies in the abnormal movement of qi,abnormal transportation and distribution of body fluid,restless ministerial fire,and abnormal exiting or entering of yin and yang caused by the dysfunction of lesser yang being the pivot.Harmonizing lesser yang is an important method to treat stable angina pectoris with insomnia,and Chaihu Longgu Muli Decoction is a representative prescription.It is illustrated by cases that harmonizing lesser yang can regulate the pivot open-close,qi movement,and body fluid transportation and distribution in an orderly manner,thus achieving smooth blood flow and peace of mind.