Speaking of insomnia, literally speaking, it can also be understood as "losing the ability to sleep".
This ability, which Chinese medicine calls "latent yang", is simply the ability to hide the yang.
As we all know, the normal sleep pattern of human body is waking up during the day and sleeping at night, which can best reflect the changes of Yin and Yang of heaven and earth, human body and the mutual induction between heaven and man.
During the day, the yang is strong, the yin is weak, the human body feels the same, and the qi and blood circulate outside; At night, the yin qi is abundant and the yang qi is weak, and the human body feels the same, and the qi and blood circulate inside. This is the law of physiological activities of the human body, which corresponds to the changes of yin and yang in nature. Therefore, the Huangdi Neijing Lingshu also records: "The husband who defends qi walks in the yang every day and in the yin at night, so he lies down when the yang is exhausted, while the yin is exhausted."
Huangdi Neijing and later doctors pointed out that the key pathogenesis of insomnia is "Yang does not enter Yin" after a lot of practice summary, just as Lingshu Xieke said: "The guest of husband's evil spirits is also, or the one who makes people unsatisfied and does not lie out ... If the qi is confined to the five internal organs, then the qi will defend itself, and it will be confined to Yang, but not to Yin ... Yin deficiency. It has already pointed out the importance of the ability of "latent yang", which can make the yang qi stable and keep a dynamic balance with the yin qi, so as to sleep normally.
In today's society, in the fast-paced, high-intensity work and life, many people often pay too much attention to the changes in the environment, and are often in a state of trepidation or irritability, which leads to restlessness, difficulty in falling asleep, shallow sleep and easy to wake up. This is mostly due to the performance of yang hyperactivity in the outside but not yin and blood, that is, yang qi can not be hidden normally in the sleep time. Among them, the common causes of abnormal "latent yang" are liver and kidney deficiency.
Chinese medicine believes that the liver can store blood and soul, and the soul can sleep normally when it enters the liver; Kidney storing essence and kidney essence are the material basis of normal physiological activities of human body, and also the basic premise for God to sleep peacefully.
If the liver and kidney are deficient, on the one hand, it will lead to hyperactivity of liver yang, which will lead to mental uneasiness, thus causing restless sleep, insomnia and dreaminess. On the other hand, kidney water is insufficient, so it can't be carried to the heart, and the heart yin can't be nourished, which leads to heart yin deficiency, loss of hidden energy, and dominance over the body. Because the heart hides the spirit, the heart yin deficiency makes the mind uneasy, thus causing insomnia.
Clinically, insomnia due to deficiency of liver and kidney is characterized by difficulty in falling asleep, waking up when sleeping, or waking up easily after many dreams, or difficulty in falling asleep after waking up, or accompanied by soreness of waist and knees, tinnitus, irritability, dizziness, feverish sensation in the five senses, red tongue and thready pulse.
Moreover, unlike short-term insomnia, liver and kidney deficiency is common in those who suffer from long-term insomnia or serious insomnia. Many people in this type of insomnia said that they had taken sleeping pills or Chinese patent medicines to soothe the nerves, but insomnia is still repeated and difficult to root out. What the hell is going on here?
In fact, this is mainly because this kind of insomnia has numerous symptoms, and it is difficult to adjust it simply by sleeping pills or tranquilizing Chinese patent medicines. Moreover, irritability, five-upset fever and so on are the signs of deficiency heat. If the medicine is used carelessly, it will often lead to more serious loss of yang and aggravate insomnia.
In addition, most of the long-term insomnia patients in clinic often have no obvious symptoms of simple yin deficiency syndrome, but they can also see other symptoms, such as yin deficiency for a long time, involving Yuanyang, which will become a syndrome of yin and yang deficiency, manifested as easy to wake up from sleep, like sleeping but not sleeping, cold hands and feet, mental fatigue, or loose stool in stool, frequent nocturia and other symptoms. If you suffer from insomnia for a long time, if you don't pay attention to it or if you don't heal for a long time, your condition can develop into "prolonged illness and blood stasis", which is manifested as insomnia all night, dull complexion, listlessness, accompanied by head swelling pain or chest tightness, palpitation, purple tongue and other symptoms.
Therefore, the treatment needs to proceed from the whole, giving consideration to both the symptoms and the root causes, or treating the symptoms first, and then cultivating the root causes, so that all the symptoms can disappear and sleep safely.
Insomnia caused by deficiency of liver and kidney, which leads to yang failing to enter yin, can be treated with Sanjia Fumai Decoction as the basic prescription.
This prescription comes from Treatise on Epidemic Febrile Diseases, and consists of Radix Glycyrrhizae Preparata, Radix Rehmanniae, Radix Paeoniae Alba, Radix Ophiopogonis, Colla Corii Asini, Fructus Cannabis, Concha Ostreae, Carapax Trionycis and Carapax et Plastrum Testudinis. It has the effects of nourishing yin, suppressing yang, clearing away heat and calming wind, and is a classic prescription for treating yin deficiency and hyperactivity of yang and excessive heat. This prescription can be flexibly added and subtracted, and it can be treated according to the syndrome, which can have good results.
62-year-old Mr. Wang has complained of repeated insomnia 10 for many years, which has worsened in the past six months. He can only get a shallow sleep for 3-4 hours every night. He has poor spirit during the day, fatigue, difficulty in falling asleep at night, dreaminess and irritability. I have taken sleeping pills, antidepressants and Chinese patent medicines, which have certain effects, but insomnia has been repeated. After insomnia worsened in recent six months, I need to take diazepam 1 tablet every night to help me sleep, but I still have poor sleep, have difficulty falling asleep, and feel dizzy and weak the next day. If I don't take diazepam, I can't sleep all night, with dry eyes, blurred vision, sore waist and knees, and occasional numbness of limbs, tinnitus, dry throat and dry mouth. Observing the tongue, it can be seen that the tongue is red with little coating. Therefore, the syndrome differentiation is yin deficiency and yang hyperactivity, and the disease is located in liver and kidney.
Treatment is to tonify liver and kidney, nourish yin and subdue yang. The prescription of Sanjiafumai Decoction is modified: Radix Rehmanniae Preparata, Rhizoma Dioscoreae, Fructus Corni, Fructus Lycii, Radix Adenophorae, Radix Ophiopogonis, Rhizoma Polygonati, Fructus Ligustri Lucidi, Eclipta prostrata, Concha Ostreae, Carapax Trionycis, Carapax et Plastrum Testudinis Preparata, Cortex Lycii, Radix Paeoniae Alba preparata, Colla Corii Asini, Semen Ziziphi Spinosae, Semen Platycladi, and Radix Glycyrrhizae Moxibustion, 14 dose per day.
During the second visit, Mr. Wang complained that his sleep condition had improved, his sleep quality had improved, and his sleeping pills could be reduced to half a tablet. He was still tired, his face was dull and lacked luster, his tongue was reddish, and his fur was thin and white. Considering that it had been effective according to the previous prescription, it took some time to nourish yin, so he told him to continue taking Shangfang 14 dose and try to stop taking sleeping pills.
At the third visit, we can see that we are in good spirits, and our face is slightly ruddy and shiny. We can fall asleep quickly within 30 minutes after taking the medicine, and we can sleep for about 6 hours every night on average. The symptoms such as dizziness and fatigue are obviously better than before. Therefore, the previous prescription removed the cortex Lycii and added raw keel and cortex Albizziae, and continued to take 30 doses every other day 1 dose to consolidate the curative effect. Follow-up shows that sleep has gradually returned to normal during the conditioning period, and there is no recurrence after one year of follow-up after drug withdrawal.
Generally speaking, the treatment of insomnia needs to take yin and yang as the general outline, grasp the essence of the disease and differentiate correctly, otherwise it will be easily confused by complicated symptoms, leading to insomnia lasting for a long time. Only on the basis of the overall concept, using individualized treatment based on syndrome differentiation, examining the causes, thinking flexibly, not sticking to one side and one medicine, not limited to one pulse and one disease, can we achieve better results.
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