| 邱一吾,赵青青,王雪姗,等.基于“肾藏精，精舍志”探讨从肾论治不寐病[J].浙江中医药大学学报,2023,47(8):857-862. |
| 基于“肾藏精，精舍志”探讨从肾论治不寐病 |
| Explore the Syndrome and Treatment of Insomnia from Kidney Based on “Kidney Stores the Essence， the Essence Stores Idea” |
| DOI：10.16466/j.issn1005-5509.2023.08.004 |
| 中文关键词: 不寐病 肾 肾藏精，精舍志 脑髓失用 营卫不和 志无所藏 辨证论治 医案 |
| 英文关键词: insomnia kidney kidney stores essence, the essence stores idea mental exhaustion disharmony between Ying and Wei idea lack of storage treatment according to syndrome differentiation medical record |
| 基金项目:浙江中医药大学2020年度国家自然科学基金预研专项资助项目(2020ZG10) |
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| 中文摘要: |
| [目的] 发挥“肾藏精，精舍志”学说，探究从肾论治不寐病的理论依据及临床意义。[方法] 阐释“肾藏精，精舍志”学说，辨析肾精对于人体睡眠的影响，探究从肾论治不寐病的理论依据。在跟师临床的基础上，综合历代医论和现代研究成果，探究“肾藏精，精舍志”理论在不寐病发生及诊治中的临床意义，总结从肾论治不寐病的辨证分型，并附医案以证其效。[结果] 肾潜藏精，充养髓海，是一切精神生理活动的基础，肾精充足人即安卧，肾精亏损人则不寐。肾精主要从生髓主脑、主外司营卫、藏神志三个方面影响人体睡眠，临床上可以采用补精生髓、调和营卫、潜藏肾志等思路来治疗不寐病。经过临床验证，从肾论治不寐，可分为肾阴亏虚型、肾精不足型、心肾不交型、肾不纳气型、肾阳浮越型等，分别辨证治疗，收效良好。所附医案，辨证属肾阴亏虚型不寐病，方选知柏地黄丸加减治疗，服药两周，停用安眠药，睡眠正常。[结论] 肾不藏精舍志，会导致脑髓不济，营卫不和，从而引起不寐病。“肾藏精，精舍志”学说对于临床治疗不寐病具有指导意义。 |
| 英文摘要: |
| [Objective] To explore the theoretical basis and clinical significance of treating insomnia based on the theory of “kidney stores essence， the essence stores idea”. [Methods] Explaining the theory of “kidney stores essence， the essence stores idea”， analyzing the influence of kidney essence on human sleep， and exploring the theoretical basis of treating insomnia from the kidney. On the basis of following the teacher’s clinical practice， this paper explores the clinical significance of the theory of “kidney stores essence， the essence stores idea” in the occurrence， diagnosis and treatment of insomnia， summarizes the syndrome differentiation of treating insomnia from the kidney， and attaches medical cases to prove its effectiveness. [Results] The kidney is the foundation of all mental and physiological activities， and those with sufficient kidney essence can sleep well， and those with kidney essence loss leads to insomnia. Kidney essence mainly affects human sleep from three aspects: nourishing the bone marrow and dominating the brain， regulating external division of Ying and Wei， and storing consciousness， and clinically it can also use such methods as tonifying the essence and rejuvenating the essence， harmonizing the Ying and Wei， and latent kidney consciousness to treat insomnia， and the effect is quite good. After clinical medical case verification， from the kidney theory to treating insomnia， it can be divided into kidney Yin deficiency type， kidney essence deficiency type， heart and kidney non-intercourse type， failure of the kidney in receiving Qi type， kidney Yang floating type， the treatment based on differentiation of symptoms and signs has achieved good results. In the attached medical record， the patient belonged to insomnia of kidney Yin deficiency type， and the prescription of Zhibai Dihuang Pill was used with modification. After treated for two weeks， the patient stopped using sleeping pills and the sleep returned to normal. [Conclusion] If the kidney doesn’t store essence or idea， it can cause mental exhaustion， disharmony of Ying and Wei， which leads to insomnia. The theory of “kidney stores essence， the essence stores idea” is of guiding significance for the clinical treatment of insomnia. |
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