任绪东从中医六经辨治不寐的临床经验

Ren Xudong's clinical experience in treating insomnia from the six-meridian syndrome differentiation of traditional Chinese medicine

不寐,现代医学多以“失眠”“睡眠障碍”相称,多表现为一段时间内常常不能正常睡眠,没有足够的睡眠时间和睡眠深度不足,从而导致躯体不适或伴有情志异常。中西医学均对本病有颇多诊治经验。任绪东主任系全国名中医,山东省名中医药专家,临证数十载,遵《内经》之说,循《伤寒》之妙,考脏腑多元之论,创立了自己独特的不寐病症诊治思路。认为其病因虽呈多元化,但均会使患者的阴阳偏颇、脏腑气血津液状态异常、经络功能失调,从而影响其营卫正常运行,而关键点在于卫气之行,其不能入于阴分使阳跷脉盛故不寐。其辨治以六经辨证为底,运用开阖枢理论,结合八纲辨证,采用“六经统病、分证合治”的思路来治疗不寐,首定阴阳主次,次用八纲辨证,之后参考兼具气血津液状态、开阖枢状态,最后统分于六经病;治疗过程中或辅以久病入络思想,或拓以五运六气思路,或酌用药证观点,或参以“六经病欲解时”理论等,经方时方不拘一格,疗效良好。

Insomnia,modern medicine is more"insomnia""sleep disorders"commensurate,more performance for a period of time often can not sleep normally,not enough sleep time and lack of sleep depth,resulting in physical discomfort or ac-companied by emotional abnormalities.Both Chinese and western medicine have a lot of experience in the diagnosis and treatment of this disease.Director Ren Xudong is a national famous traditional Chinese medicine expert and a famous expert of traditional Chinese medicine in Shandong Province.He has been dealing with insomnia for decades.Following the theory of Inner Canon of Huangdi and the wisdom of Treatise on Febrile Diseases,researching the theory of diversity of zangfu or-gans,he created his own unique thought of diagnosis and treatment of insomnia.It is believed that although the cause of the disease is diversified,it will make the yin and yang bias,the abnormal state of qi-blood-fluid,and the dysfunction of merid-ians,which will affect the normal operation of the nutrient and defense,and the key point is the travel of the defense qi,which cannot enter the yin and make the yangqiao meridian excessive.Based on the syndrome differentiation of the six meridians,it adopts the theory of open-close-pivot,combined with the eight principal syndrome differentiation,and adopts the idea of"uniting disease of the six meridians and combining treatment of syndrome differentiation"to treat insomnia,first determining the primary and secondary of yin-yang,then using the eight principal syndrome differentiation,and then refer-ring to both the state of qi-blood-fluid and the state of open-close-pivot,and finally focusing on the six meridians syn-dromes.In the treatment process,or supplemented by the idea of chronic disease into collaterals,or to extend the idea of doctrine of five evolutive phases and six climatic factors,or to consider the view of drug-syndrome correspondence,or to par-ticipate in the theory of"time for relief of six meridians syndromes",etc.,the prescription is eclectic and the effect is good.