摘要
“形不足者,温之以气”最早载于《黄帝内经》,意为应用温阳益气法论治阳气亏损发展而成的虚性疾病。老年失眠症多以形、气不足为主要病因,气之不足为其病机关键,五脏之气不足均可致五神所伤而导致不同类型的失眠。然辨证失眠又不可只拘泥于“虚”字。根据老年失眠症的临床表现,可分别予温肺气、温心气、温脾气、温肝气、温肾气五大温法治之。温肺气以养魄,可予补肺汤,兼用桔梗等宣肺药物;温心气以养神,可予桂枝甘草龙骨牡蛎汤,兼用丹参、当归等活血药物;温脾气以养意,可予归脾汤,兼用山楂、鸡内金等和胃药物;温肝气以养魂,可予乌梅丸,兼用柴胡、香附等疏肝药物;温肾气以养志,可予金匮肾气丸,兼用龙骨、牡蛎等重镇药物。
The theory of"warming with Qi for those with insufficient form"was first proposed in Huang Di Nei Jing,which means that the method of warming Yang and replenishing Qi can be applied to treat deficiency-type diseases caused by a decline of patients′Yang Qi.Elderly insomnia is often primarily caused by a deficiency of form and Qi,with the latter being the key pathological mechanism.Deficiency of Qi in the Five Zang can damage the Five Shen,leading to different types of insomnia.However,diagnosing insomnia should not be confined to"deficiency"alone.According to the clinical manifestations of elderly insomnia,treatment can be applied separately through five warming methods:warming Lung Qi,warming Heart Qi,warming Spleen Qi,warming Liver Qi as well as warming Kidney Qi.Warming Lung Qi to nourish the Po,i.e.with Bufei Decoction along with Lung-dispersing herbs such as Jiegeng(Platycodon);warming heart Qi to nourish the Shen,i.e.with Guizhi Gancao Longgu Muli Decoction combined with blood-activating herbs such as Danshen(Salvia)and Danggui(Angelica);warming Spleen Qi to nourish Yi,i.e.with Guipi Decoction along with stomach-harmonizing herbs such as Shanzha(Hawthorn)and Jineijin(Chicken′s gizzard lining);warming Liver Qi to nourish Hun,i.e.with Wumei Pill combined with liver-soothing herbs such as Chaihu(Bupleurum)and Xiangfu(Cyperus);warming Kidney Qi to nourish Zhi,i.e.with Jingui Shenqi Pill along with heavy-settling herbs such as Longgu(Ossa draconis)and Muli(Oyster).
作者
庞浩宇
陈旭
曹竟
贾茜麟
郗凌云
白杨
洪霞
PANG Haoyu;CHEN Xu;CAO Jing;JIA Qianlin;XI Lingyun;BAI Yang;HONG Xia(Xi Yuan Hospital,China Academy of Chinese Medical Sciences,Beijing China 100091;Beijing University of Chinese Medicine,Beijing China 100029)
出处
《中医学报》
2025年第12期2549-2554,共6页
Acta Chinese Medicine
基金
中国中医科学院科技创新工程重大攻关项目(CI2021A01312)。
关键词
老年失眠症
“形不足者
温之以气”
补肺汤
桂枝甘草龙骨牡蛎汤
归脾汤
乌梅丸
金匮肾气丸
elderly insomnia
"warming with Qi for patients with insufficient form"
Bufei Decoction
Guizhi Gancao Longgu Muli Decoction
Guipi Decoction
Wumei Pill
Jingui Shenqi Pill
