| 任可,王磊,曹灵勇.探析《伤寒论》柴胡类方在少阳证不寐中的施治规律[J].浙江中医药大学学报,2024,48(12):1600-1603. |
| 探析《伤寒论》柴胡类方在少阳证不寐中的施治规律 |
| Analysis of the Treatment Regularity of Chaihu Prescriptions in Treatise on Febrile Diseases for Insomnia of Shaoyang Syndrome |
| DOI：10.16466/j.issn1005-5509.2024.12.019 |
| 中文关键词: 不寐 少阳病 《伤寒论》 柴胡类方 柴胡桂枝干姜汤 六经辨证 经方 调和阴阳 |
| 英文关键词: insomnia Shaoyang disease Treatise on Febrile Diseases Chaihu prescriptions Chaihu Guizhi Ganjiang Decoction six meridian syndrome differentiation classical prescriptions harmonizing Yin and Yang |
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| 中文摘要: |
| [目的] 探讨少阳证不寐的病机，并结合《伤寒论》中柴胡类方的特点，探析《伤寒论》柴胡类方在少阳证不寐中的施治规律。[方法] 通过分析《黄帝内经》《伤寒论》等文献中关于不寐病机的认识，探讨不寐与少阳病的理法关联，并结合疾病临床表现与六经病机分类，归纳柴胡类方在不寐治疗中的应用。[结果] 从六经辨证的角度来看，存在少阳证型的不寐，其基本病机为机体营卫俱弱，表邪入里，郁结少阳，枢机不利，水火气血疏布失调，导致心神不安，神不守舍。《伤寒论》柴胡类方中邪犯少阳者，以和解少阳、调达枢机为治法，治疗以小柴胡汤为主；邪犯少阳兼阳明里实者，以和解少阳、通下里实为治法，治疗以大柴胡汤为主；邪犯少阳兼厥阴水热者，以清散内郁、涤荡水热为治法，治疗以柴胡加龙骨牡蛎汤为主；邪犯少阳兼太阴水饮者，以和解少阳、调和肝脾、温化水饮为治法，治疗以柴胡桂枝干姜汤为主。[结论] 不寐病与《伤寒论》少阳证理法关联密切，以和解少阳为主要治则。总结柴胡类方在少阳证不寐中的施治规律，可为不寐的临床诊疗提供新的思路和方法。 |
| 英文摘要: |
| [Objective] To explore the pathogenesis of insomnia in Shaoyang syndrome， and combined with the characteristics of Chaihu prescriptions in Treatise on Febrile Diseases，to explore the rules of treatment regularity of Chaihu prescriptions in Treatise on Febrile Diseases for insomnia of Shaoyang syndrome. [Methods] By analyzing the understanding of insomnia pathogenesis in Huangdi Neijing and Treatise on Febrile Diseases， the theoretical and practical associations between insomnia and Shaoyang disease were explored. Combined with the clinical manifestations and the classification of six-meridian pathogenesis， the application of Chaihu prescriptions in the treatment of insomnia was summarized. [Results] From the perspective of six-meridian syndrome differentiation， there is insomnia of Shaoyang syndrome， whose basic pathogenesis is that the body’s nutrient and defense are weak， the exterior pathogen enters the interior， the Shaoyang is blocked， the pivot is unfavorable， the water， fire， Qi and blood are distributed improperly， leading to mental restlessness and uncontrollable. In the Chaihu prescriptions of Treatise on Febrile Diseases， for the pathogen attacking Shaoyang， the treatment principle is to reconcile Shaoyang and regulate the pivot， and mainly uses Xiaochaihu Decoction; for the pathogen attacking Shaoyang and Yangming leading to constipation， the treatment principle is to reconcile Shaoyang and facilitate bowel movement， and mainly uses Dachaihu Decoction; for the pathogen attacking Shaoyang and Jueyin water heat， the treatment principle is to clear away internal depression and purge water heat， and mainly uses Chaihu and Longgu Muli Decoction; for the pathogen attacking Shaoyang and Taiyin water drinking， the treatment principle is to reconcile Shaoyang， reconcile the liver and spleen， and warm and resolve retained fluid， and mainly uses Chaihu Guizhi Ganjiang Decoction. [Conclusion] Insomnia is closely related to Shaoyang syndrome， and the main treatment is to reconcile Shaoyang. To summarize the rules of treatment regularity of Chaihu prescriptions in Treatise on Febrile Diseases for insomnia of Shaoyang syndrome， can provide a new idea and method for clinical diagnosis and treatment of insomnia. |
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