Have you slept well recently? Have you ever worried about insomnia? On that night when you should have fallen asleep, you tossed and turned in bed and couldn't sleep. If you only suffer from insomnia occasionally, you can improve this problem by developing good sleep habits; If this is the case for a long time, I'm afraid it will be treated with drugs. Sun Guangrong, a master of traditional Chinese medicine, summarized his experience in treating insomnia as follows.
Main pathogenesis, syndrome differentiation and treatment of insomnia
Insomnia is caused by yin-yang imbalance, liver depression and mental malnutrition. Some scholars advocate that regulating the yin and yang of the heart, spleen, liver and kidney, nourishing the heart and calming the nerves, soothing the liver and relieving depression are the main principles for treating insomnia. Some scholars believe that insomnia is caused by internal injuries, and the main reason is emotional exhaustion. Deficiency syndrome is the main clinical symptom, especially in elderly patients. And "the liver is the source of all diseases and the heart is the place where all diseases spread", and the heart, liver, spleen and stomach are closely related to insomnia. The principle of treatment should be to harmonize the liver and spleen, calm the heart and soothe the nerves. Some scholars also think that the treatment method of warming up the yang and attracting dragons into the sea can be adopted.
Theoretical innovation and main prescription
Professor Sun Guangrong believes that insomnia is mostly caused by deficiency of both heart and spleen, which leads to prolonged qi deficiency and blood stasis, or stagnation of liver qi and blood stasis, so it is necessary to replenish qi and promote blood circulation, or promote qi and blood circulation. Spleen is the source of phlegm, and lung is the reservoir of phlegm. Body fluid metabolism is abnormal, and fire turns into phlegm. All stubborn diseases are mostly caused by phlegm, especially patients with intractable insomnia. Treatment should be clearing away heat and resolving phlegm. If yin deficiency leads to excessive internal heat, anxiety and irritability, the treatment should be to clear the heart and soothe the nerves. Professor Sun Guangrong made Sun Shi Anshen Zhi Ding Decoction to treat insomnia and anxiety according to Zhang Zhongjing's synopsis of the Golden Chamber. Its formula consists of Radix Codonopsis, Radix Astragali, Radix Salviae Miltiorrhizae, Rhizoma Pinelliae Preparata, Pericarpium Citri Tangerinae, Radix Curcumae, Poria, Semen Ziziphi Spinosae, Juncus Juncus, Bamboo Leaves, Fructus Forsythiae, Caulis Polygoni Multiflori and Oranges. Take it in the morning and evening
Prescription: Radix Codonopsis, Radix Notoginseng, and Radix Salviae Miltiorrhizae as monarch drugs, Rhizoma Pinelliae, Pericarpium Citri Tangerinae, and Radix Curcumae as ministerial drugs, Poria, Semen Ziziphi Spinosae, Juncus Juncus, and Folium Bambusae as adjuvant drugs, Fructus Forsythiae, Caulis Polygoni Multiflori, flour, Fructus Jujubae, and Radix Glycyrrhizae as emissaries, and * * * plays "Yiqi, Huoxue, Huatan and Ruangan". Insomnia can be divided into deficiency of both heart and spleen and hyperactivity of fire due to yin deficiency. Longan meat 15g is added to those without fire, and Lingci 15g is added to those with fire. Longya10g; Be added to those who are easily frightened; Acorus gramineus 10g and polygala tenuifolia10g are added for patients with depression or hypomnesia; Motherwort and Cyperus rotundus are added to patients with late menstruation or menopause, each12g; ; Cortex Albiziae Maniaga 10g, magnet 5g, and concha Haliotidis 20g；; For climacteric syndrome, Radix Bupleuri 12g, Cortex Lycii 10g and Carapax Trionycis15g are added; ; For those with severe night sweats, floating wheat 15g, floating wheat10g; Adding ephedra root; Patients with internet addiction are added with polygala tenuifolia10g, Acorus gramineus10g, Cortex Albizziae10g, and magnet 5g.
In the clinical treatment of insomnia, we should pay attention to the following three points: first, we should pay attention to the theory of "restless up and down", second, we should pay attention to the method of ascending and descending, and third, we should pay attention to "heart", which governs the spirit. Insomnia is related to the brain, but in fact it is in the heart. Therefore, the treatment of insomnia should be based on "the mind governs the spirit". In the treatment based on syndrome differentiation, "emphasizing form and spirit, regulating qi and blood, leveling up and down, and leveling in and out". The heart is the monarch, governing the blood and consolidating the five internal organs. So it is the disharmony between the five internal organs that leads to insomnia. The root cause of disharmony between zang-fu organs is "restless up and down", that is, disharmony between mother and child, which refers to the relationship between five zang-organs.
According to the pathogenic theory of six qi in Huangdi Neijing, the harmony of viscera can be achieved by regulating the mother or child viscera of viscera, and the therapeutic effect of "up and down" can be achieved. Attention should be paid to the reinforcing and reducing methods of viscera in clinical medication. For example, "Difficult Classics and Sixty-six Difficult Classics" says: "To make up for his mother in vain is to save his son." "seventy-seven difficult classics" said: "when you see the disease of the liver and know that it is transmitted from the liver to the spleen, you must first get a temper and suffer from the evil of the liver without orders." According to the relationship between the five zang-organs, the basic treatment methods are formulated, such as nourishing water and containing wood, combining gold with water, cultivating soil and generating gold, etc. Anyone with spleen and stomach weakness should strengthen the spleen and replenish qi; If internal heat due to yin deficiency disturbs the heart, clearing the heart and calming the nerves, ensuring that the heart fire goes down, the kidney water is moist, and the fire and water are ji ji, then the spirit is safe and refreshed. The intractable insomnia is mostly caused by blood stasis and phlegm turbidity. Long-term illness entering collaterals should promote blood circulation and remove blood stasis.
Examples of medical records
Sun, male, 60 years old. I have been insomnia for 6 months, sleeping by sleeping pills, and my urine is yellow. The tongue is red, the coating is yellow and greasy, and the pulse is heavy and slippery.
Chinese medicine diagnosed insomnia.
Syndrome differentiation in traditional Chinese medicine is qi deficiency and blood stasis, and phlegm-fire disturbs the mind.
Pathogenesis analysis: the heart governs the blood vessels, the spirit and the five internal organs. Being calm means being calm, and being distracted means being upset. Deficiency of qi and blood in the heart, viscera dystrophy, or qi deficiency and blood stasis, resulting in heart pulse dystrophy; Or liver qi stagnation, prolonged fire, phlegm in semen, phlegm-fire disturbing the heart, anxiety, insomnia, anorexia and moderate anxiety are also not suitable; Yellow urine with internal heat; The pulse is heavy and slippery, the tongue is red and the coating is yellow and greasy, qi deficiency and phlegm resistance, and damp heat are also inherent.
Treatment principles and methods: benefiting qi and activating blood, resolving phlegm and clearing heat, calming the heart and calming the nerves.
Chinese medicinal formula: 5g of American ginseng, 5g of raw astragalus, 0g of salvia miltiorrhiza10g, 2g of poria cocos10g, 5g of fried Ziziphus Spinosae seed10g, 5g of Juncus Juncus, 0g of prepared Pinellia ternata10g of dried tangerine peel10g, 6g of lophatherum gracile and 6g of forsythia.
American Ginseng
Prescription analysis shows that Panax quinquefolium, Radix Notoginseng and Radix Salviae Miltiorrhizae are the monarch drugs. Poria cocos, fried jujube kernels and Juncus Juncus are the minister medicine groups. Rhizoma Pinelliae Preparata, Pericarpium Citri Tangerinae, and Folium Bambusae for clearing heart, with * * * as the adjuvant group; Fructus forsythiae shell and Polygoni Multiflori Radix. Has the effects of invigorating kidney, dredging collaterals, clearing away heart fire and calming nerves. Raw licorice blends all kinds of drugs.
Professor Sun Guangrong, who promoted the concept of a new teacher, believes that all the five internal organs are in the heart, and peace of mind is when you are quiet, but you are upset when you are scattered. The combination of yunshenfu and fried jujube kernel can calm the mind and soothe the nerves. Shen Fu, who was born in Matsushita, got a loose essence, which is the top quality of materia medica. Long service can prolong life. Shennong's Classic of Materia Medica said: "The main chest is threatened by unfavorable qi, with anxiety, fright, heartache, cold and heat, cough and dry mouth, which is beneficial to urination." Ziziphus jujuba seed is a holy medicine. Shennong's Herbal Classic says, "I can't sleep if I'm upset." Shen Fu holds loose roots, Yang contains Yin, Ziziphus jujuba Bunge gives birth to treetops, and Yin contains Yang. Shen Fu and Ziziphus jujuba Bunge are in harmony, and they are a pair of peaceful mandarin ducks. Anxiety, depression, insomnia, forgetfulness, etc. It belongs to mental disorder, so you should choose longan meat, magnet, dragon teeth and rush to match it. All the above symptoms belong to deficiency of both heart and spleen, and longan meat is added; For those disturbed by deficiency fire, add rush. If liver fire is inflamed, add Lingmagnetism. People who are afraid of dreams will have dragon teeth. The heart is the official of the monarch, and all palpitations and chest tightness are due to the deficiency of heart yang, so it should be combined with Guizhi to help the heart yang.
In addition, Professor Sun Guangrong believes that insomnia is closely related to the heart and liver, which is caused by the disharmony between qi and blood. Because "the heart governs the blood vessels", "the heart governs the spirit" and "the liver stores blood" and "the liver governs the catharsis", the deficiency of qi and blood in the heart can not nourish the viscera, or the liver loses the catharsis, which will lead to the loss of heart blood, and the stagnation of liver qi will turn into fire for a long time, leading to insomnia. Its treatment is to replenish qi and nourish blood, calm the heart and soothe the nerves, soothe the liver and relieve depression, and make qi and blood flow smoothly. The basic prescription is Sun Shi Yangxin Yu Kai Decoction (prescription: Radix Pseudostellariae 10g, Radix Astragali 15g, Radix Salviae Miltiorrhizae 10g, Poria, Semen Ziziphi Spinosae 15g, Concha Margarita 15g, Radix Polygalae15g. If insomnia is caused by disharmony between stomach and heart-fire, Dendrobium, Ophiopogon japonicus and Massa Medicata Fermentata are given to nourish yin and stomach, and Plantaginis seeds can reduce fire. Commonly used drugs for nourishing yin and regulating stomach for insomnia include Radix Pseudostellariae, Radix Astragali, Poria, Semen Ziziphi Spinosae, and Radix Ophiopogonis. Juncus Juncus assists Poria and Semen Ziziphi Spinosae in clearing the heart and calming the nerves, while Massa Medicata Fermentata assists Dendrobium and Radix Ophiopogonis in nourishing yin and regulating stomach.
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