栀子豉汤治疗失眠的研究进展

Research progress on the treatment of insomnia with Zhizichi Decoction

栀子豉汤出自《伤寒论·辨太阳病脉证治》,该方由栀子、香豉组成,可治疗“虚烦不得眠”“胸中窒”“心中懊侬”“心中结痛”“三阳病”及杂病诸证。失眠是常见的神经系统疾病,其严重影响了患者的日常生活及心理状态。目前对于失眠的主要治疗方式仍以药物干预为主,但由于其成瘾性、嗜睡等副作用,往往临床疗效不理想,患者依从性差。栀子豉汤作为治疗失眠的经方、常用方,近年来探究其治疗失眠的临床研究逐渐增多,笔者为此对其进行综述。由于栀子豉汤的组成简单,功效专一,因此常与酸枣仁汤、归脾汤等合用,治疗更为复杂的病机。栀子豉汤还常与针刺疗法联合治疗失眠患者,以有效提高临床有效率。栀子豉汤治疗失眠的机制可能为炎症介质通路、神经递质通路、内分泌通路等。

Zhizichi Decoction comes from“Treatise on Febrile Diseases·Differential Diagnosis and Treatment of Taiyang Disease”.The prescription consists of Zhizi and Xiangchi,which can treat various syndromes such as“restlessness and insomnia”“chest constriction”“irritability in the heart”“pain and knotting in the heart”“three yang diseases”and miscellaneous diseases.Insomnia is a common neurological disease that severely affects patients’daily life and psychological state.Currently,the main treatment for insomnia is still drug intervention.However,due to side effects such as addiction and lethargy,the clinical efficacy is often unsatisfactory,and patient compliance is poor.In recent years,there has been an increasing number of clinical and experimental studies exploring the use of Zhizichi Decoction,a classical and commonly used prescription for insomnia.This article provides a review of these studies.Because of its simple composition and specific efficacy,Zhizichi Decoction is often combined with other prescriptions such as Suanzaoren Decoction and Guipi Decoction to target more complex pathologies.Zhizichi Decoction is also often used in combination with acupuncture therapy to treat insomnia patients,effectively improving the clinical effective rate.The mechanism by which Zhizichi Decoction treats insomnia may involve inflammatory mediator pathways,neurotransmitter pathways,and endocrine pathways.