| 林志豪,叶威,蒋越,等.朱文宗教授基于伤寒派腹诊辨治神经性失眠临床经验探析[J].浙江中医药大学学报,2022,46(9):964-968. |
| 朱文宗教授基于伤寒派腹诊辨治神经性失眠临床经验探析 |
| Experience of Professor ZHU Wenzong in Treatment of Neuropathic Insomnia Based on Abdominal Examination of Shanghan School |
| DOI：10.16466/j.issn1005-5509.2022.09.005 |
| 中文关键词: 伤寒派腹诊 神经性失眠 痰阻气滞 医案 名医经验 朱文宗 |
| 英文关键词: abdominal examination of Shanghan school neuropathic insomnia phlegm obstruction and Qi stagnation medical case experience of famous doctor ZHU Wenzong |
| 基金项目:浙江省自然科学基金项目(LY18H270001) |
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| 中文摘要: |
| [目的] 探讨朱文宗教授基于伤寒派腹诊辨治神经性失眠的临床经验。 [方法] 通过跟师临诊，归纳总结朱文宗教授运用伤寒派腹诊辨治神经性失眠的腹证分型及处方用药，并附加医案一则佐证。[结果] 朱教授认为，神经性失眠的基本病机是营卫失和，脏腑不调，依据腹诊辨证，可分虚实两类。虚者腹软无力，提示气虚气陷；腹皮灼热，乃阴虚火旺。实者胸胁苦满，肝郁化火；心下悸动，水气上逆；心下痞满，痰阻气滞；心下按痛，痰热交阻；腹部压痛，瘀血内存。结合患者全身症状及舌脉，随证处方加减，疗效颇佳。所附验案中患者腹软无力，并伴短气乏力、脉细弱无力等气虚表现，以补中益气汤补气助眠，疗效显著。 [结论] 朱教授以伤寒派腹诊作为辨证治疗神经性失眠的重要依据，腹诊可操作性强，为辨证提供了明确的方向，临床卓有成效，其经验值得借鉴和应用。 |
| 英文摘要: |
| [Objective] To discuss the experience of Professor ZHU Wenzong in treatment of neuropathic insomnia based on abdominal examination of Shanghan school. [Methods] Through clinical follow-up learning， this paper summarized the experience of Professor ZHU in treating neuropathic insomnia based on abdominal examination of Shanghan school， and analyzed syndrome differentiation and prescription. And a case was attached to support it. [Results] Professor ZHU believes that the basic pathogenesis includes disharmony of nutritive Qi and defensive Qi and dysfunction of viscera， which can be divided into deficiency syndrome and excess syndrome based on abdominal examination. Soft abdomen indicates Qi deficiency and Qi collapse; hot abdominal skin indicates Yin deficiency and fire hyperactivity. Fullness and discomfort in chest and hypochondrium indicate fire derived from stagnation of liver Qi; gastric palpitation prompts ascending of water and Qi; fullness of the gastral cavity indicates phlegm obstruction and Qi stagnation; stomach tenderness makes clear obstruction of phlegm and heat; abdominal tenderness indicates blood stasis. Combined with the patient‘s systemic symptoms， tongue and pulse， medicine is added and subtracted， finally achieving curative effect. In the case， the patient‘s abdomen was soft， accompanied with shortness of breath and weak pulse， Buzhong Yiqi Decoction was used and achieved remarkable effect. [Conclusion] Professor ZHU takes abdominal examination of Shanghan school as an important basis for syndrome differentiation and treatment of neurological insomnia， which has strong operability and provides a clear direction for syndrome differentiation， proved to be clinically effective. Professor ZHU’s experience is worthy of reference and application. |
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