| 张若怡,顾锡镇.顾锡镇教授辨证治疗失眠经验研究[J].浙江中医药大学学报,2019,43(5):453-456, 459. |
| 顾锡镇教授辨证治疗失眠经验研究 |
| Research of Professor GU Xizhen’s Experience of Dialectical Treatment of Insomnia |
| DOI：10.16466/j.issn1005-5509.2019.05.015 |
| 中文关键词: 失眠 不寐病 辨证论治 瘀热 医案 顾锡镇 名医经验 |
| 英文关键词: agrypnia insomnia treatment based on syndrome differentiation stagnated heat medical records GU Xizhen famous doctor's experience |
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| 中文摘要: |
| [目的]总结顾锡镇教授治疗失眠的临床经验。[方法]通过临床跟诊、聆听讲授，收集整理相关临床资料，从失眠的病因病机、治则治法等方面探讨顾教授治疗本病的经验，归纳用药特点及加减规律，并予典型病案分析。[结果]顾师认为，失眠辨证以实证多见，分肝气郁结证、肝郁化火证、痰热内扰证及瘀热证，治疗上分别以疏肝解郁、清肝泻火、清热化痰、凉血化瘀药物配伍重镇安神之品；虚证以心脾两虚证多见，治疗上以养心安神为主。所举验案中肝气郁结证，治以疏肝解郁、重镇安神，以柴胡疏肝散合龙骨牡蛎散加减治疗；肝郁化火证，治以清肝泻火、重镇安神，以丹栀逍遥散加减治疗；痰热内扰证，治以清热化痰、重镇安神，以菖蒲郁金汤加减治疗；瘀热证，治以凉血化瘀、重镇安神，以犀角地黄汤加减治疗；心脾两虚证，治以养心安神，以百合地黄汤加减治疗。以上验案均获得良好疗效。[结论]顾锡镇教授认为失眠辨证实多虚少，强调本病以重镇安神和养心安神为治疗大法，辅以疏肝、清火、化痰、祛瘀等，临床效果显著，值得借鉴。 |
| 英文摘要: |
| [Objective] To summarize the clinical experience of Professor GU Xizhen in treatment of insomnia.[Methods] Through clinical follow-up, listening to lectures, collecting and sorting out relevant clinical data, Professor GU's experience in treatment of insomnia from the aspects of etiology, pathogenesis, treatment principles and methods was discussed, the characteristics of medication and the law of addition and subtraction was summarized, and typical cases were presented.[Results] According to Professor GU, insomnia syndrome differentiation is more common with empirical evidence, including liver Qi stagnation syndrome, fire derived from stagnation of liver Qi syndrome, internal disturbance of phlegm-heat syndrome and stagnated heat syndrome, deficiency syndrome is more common with insufficiency of heart and spleen syndrome. In treatment of deficiency syndrome, tranquilization with heavy material is taken as the fundamental method, combined with the methods of soothing the liver, clearing the fire, resolving phlegm, removing blood stasis and so on, and deficiency syndrome is treated with the principle of nourishing the heart and tranquilizing the nerves. And Professor GU creatively applied the concept of "stagnated heat" pathogenesis to the syndrome differentiation and treatment of refractory insomnia. The case of liver Qi stagnation was treated with addition and subtraction of Chaihu Shugan powder and Longgu Muli powder according to the principle of dispersing stagnated liver Qi and tranquilization with heavy material; the case of fire derived from stagnation of liver Qi was treated with addition and subtraction of Danzi Xiaoyao powder according to the principle of clearing the fire and tranquilization with heavy material; the case of interior disturbance of phlegm-heat was treated with addition and subtraction of Changpu Yujin decoction according to the principle of clearing away heat, reducing phlegm and tranquilization with heavy material; the case of stagnated heat syndrome was treated with addition and subtraction of Xijiao Dihuang decoction according to the principle of cooling blood to dissipate blood stasis and tranquilization with heavy material; the case of insufficiency of heart and spleen was treated with addition and subtraction of Baihe Dihuang decoction according to the principle of nourishing the heart and tranquilizing the nerves. All cases achieved good results.[Conclusion] Professor GU Xizhen believes that insomnia is more excess and less deficiency, and emphasizes that this disease takes tranquilization with heavy material and tranquilization by nourishing the heart as the major method, supplemented by other treatment, which has significant clinical effects and is worthy of reference. |
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