基于“血实宜决之”辨治老年慢性失眠

Treatment of Chronic Insomnia in the Elderly Based on“Blood Excess Should Be Dissolved”

“血实宜决之”出自《素问·阴阳应象大论》,意为通过针药并用祛邪逐瘀以治疗血瘀壅滞等血实之象。慢性失眠是老年人的常见病,瘀血内阻是老年慢性失眠的核心病机。临床治疗老年慢性失眠可遵循“血实宜决之”治则,以血府逐瘀汤为基础方,根据肝郁、痰火、阴虚、气虚、血虚等不同致瘀原因加减化裁,同时配合针刺、耳穴等疗法,以提高疗效。

“Blood excess should be dissolved”comes from Plain Conversation·Major Discussion on the Theory of Yin and Yang and the Coresponding Relationships Among All the Things in Nature,which refers to that the symptoms of blood stasis and blood stagnation are treated with acupuncture and medicine.Chronic insomnia is a common disease in the elderly,and internal accumulation of blood stasis is the core pathogenesis of chronic insomnia in the elderly.Clinical treatment of chronic insomnia in the elderly can follow the treatment principle of“blood excess should be dissolved”and Xuefu Zhuyu Decoction(血府逐瘀汤)is given as the basic prescription,which is modified according to different causes of blood stasis such as liver stagnation,phlegm fire,yin deficiency,qi deficiency,and blood deficiency,etc.At the same time,acupuncture,auricular points and other therapies can be combined to improve the curative efficacy.