文章摘要
贾兆星,王斌,陈丽莹,等.林咸明教授针药结合治疗失眠的经验介绍[J].浙江中医药大学学报,2022,(6):661-664.
林咸明教授针药结合治疗失眠的经验介绍
Introduction of Professor LIN Xianming‘s Experience in the Treatment of Insomnia by Combining Acupuncture and Medication
DOI:10.16466/j.issn1005-5509.2022.06.016
中文关键词: 失眠  针药结合  医案  临床经验  传承  名老中医  林咸明
英文关键词: insomnia  combination of acupuncture and medication  medical cases  clinical experience  inheritance  famous doctor of traditional Chinese medicine  LIN Xianming
基金项目:林咸明名中医工作室项目(浙卫发[2018]69号);浙江省中医药科学研究基金项目(2022ZA086);浙江省中医药重点学科建设计划(针灸学脑病)项目(2017-XK-A18)
作者单位
贾兆星 浙江中医药大学第三临床医学院 杭州 310053 
王斌 浙江中医药大学附属第三医院 
陈丽莹 浙江中医药大学第三临床医学院 杭州 310053 
林咸明 浙江中医药大学第三临床医学院 杭州 310053
浙江中医药大学附属第三医院 
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中文摘要:
      [目的] 总结林咸明教授针药结合治疗失眠的诊治思路及临床经验,从而更好地指导临床治疗。[方法] 通过临床跟诊,收集、分析林师针药结合治失眠的验案,从“针刺调神为先”“谴方调体为本”两个方面介绍其针药结合治疗失眠的临床思路及经验,并举验案一则加以佐证。[结果] 林师认为,失眠的病因病机主要为邪气扰神,神乱不寐;五脏虚损,神失所养。临床治疗中,林师倡导“针刺调神为先,遣方调体为本”,常使用其独创的调神针法调脑神、安五脏之神,使神安则寐;并重视使用经方“方-病-人”的诊疗思维选方用药,调整患者体质,使神无邪扰、神有所养,临床疗效突出。病案中患者因邪气扰神,神乱不寐,辨其体质为大柴胡汤体质,针刺以调神针法随证配穴安神祛邪;选用大柴胡汤加减,调体固本,针药同施,诸症悉除。[结论] 林师临床治疗失眠重视“神、体”同调,运用调神针法调神安眠,中医经方调体固本,临床疗效突出,其经验可供临床借鉴。
英文摘要:
      [Objective] To summarize Professor LIN Xianming‘s diagnosis and treatment ideas and clinical experience in the treatment of insomnia by combination of acupuncture and medication, in order to better guide clinical treatment. [Methods] Through studying with Professor LIN, collecting and analyzing the relevant medical cases of insomnia, this paper introduced the clinical thinking and experience of the diagnosis and treatment of insomnia by Professor LIN from two aspects of “acupuncture adjusting the spirit comes first, dispatch prescription to adjust the body as the main treatment principle”, then cited a case to support above content. [Results] Professor LIN believes that the etiology and pathogenesis of insomnia are mainly the evil disturbing the spirit, which cannot lead to sleep; then the five viscera are weak and damaged, the spirit loses its support. In clinical treatment, Professor LIN advocates “acupuncture adjusting the spirit comes first, dispatch prescription to adjust the body as the main treatment principle”, and mainly uses his original spirit adjusting acupuncture to adjust the brain spirit and the spirit of the five viscera to make the spirit relaxed, then leads to sleep; at the same time pays attention to the use of the classic prescription, selects prescription and uses medication based on diagnosis and treatment thinking of “prescription-disease-patient” to adjust the patient‘s constitution, so that spirit is no longer disturbed by the evil and has sufficient support, this treatment has outstanding clinical efficacy. The patient in the case was the evil disturbing the spirit, which cannot lead to sleep, so the constitution was of Dachaihu Decoction, and the patient was treated with the spirit-adjusting acupuncture and matching acupoints to make the spirit relaxed and get rid of the evil; meantime, added and subtracted Dachaihu Decoction was selected to adjust and strengthen body, combined with acupuncture and medicine, so all symptoms disappeared. [Conclusion] Professor LIN Xianming emphasizes adjusting both “body and spirit” in clinical treatment of insomnia, and uses spirit-adjusting acupuncture to adjust the spirit and sleep, selects classical prescription to adjust and strengthen the body, these experiences have outstanding clinical effects, which can be used for reference in clinic.
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