摘要
围绝经期是女性生殖生理的重要转折阶段,因体内雌激素水平波动及下丘脑-垂体-肾上腺轴(HPA轴)功能紊乱,常引发以失眠为核心的复杂多样症状。其中,围绝经期失眠(perimenopausal insomnia,PPI)为该阶段的常见病症,中医将其归属于“绝经前后诸证”以及“不寐”范畴,病机责于肾虚。《黄帝内经》载:“肾者主蛰,封藏之本,精之处也。”此理论历经演变而内涵丰富,其封藏作用不仅包括对肾精的固藏,也体现在对阳气的封藏与蓄养。基于中医“肾为封藏之本”理论,笔者认为围绝经期女性天癸渐竭,肾虚失于封藏阳气,阳不入于阴而引起失眠。该文通过文献溯源与诠析,梳理了“肾为封藏之本”的理论要义,并论述肾封藏阳气理论的内涵及理论依据,基于“肾封藏阳气”理论对围绝经期失眠的发病机理进行阐释。此外,该文基于肾主封藏功能探讨HPA轴负反馈系统以及皮质醇分泌的昼夜节律机制,探寻传统中医理论与现代生理学的内在联系,为临床从“补肾封藏阳气”角度治疗围绝经期失眠提供跨学科理论支撑与创新思路。
Perimenopause is an important turning point of female reproductive physiology.The fluctuation of estrogen level and the dysfunction of hypothalamus-pituitary-adrenal axis(HPA axis)often cause complex and diverse symptoms with insomnia as the core.Among them,perimenopause insomnia(PPI)is a common disease in this stage.Traditional Chinese medicine classifies it into the category of“menopausal and perimenopausal symptoms”and“insomnia”,and the pathogenesis is due to kidney deficiency.It is recorded in the Huangdi Neijing:“The kidney governs the mechanism of conservation,constituting the root foundation of sealing and storage,and serves as the repository where essence is stored.”This theory has evolved and has rich connotation.Its function of storage not only includes the solid storage of kidney essence,but also embodies the storage and cultivation of Yang Qi.Based on the theory of“kidney is the root of storing”in traditional Chinese medicine,the author thinks that insomnia is caused by the gradual exhaustion of the kidney in perimenopause women,the loss of Yang Qi in storing Yang Qi due to kidney deficiency,and the failure of Yang Qi to enter Yin Qi.This paper,through literature tracing and interpretation,combs out the theoretical essence of“kidney is the root of sealing”and discusses the connotation and theoretical basis of the theory of“kidney sealing Yang”,and explains the pathogenesis of perimenopause insomnia based on the theory of“kidney sealing Yang”.In addition,based on the function of kidney,this paper discusses the negative feedback system of hypothalamic-pituitary-adrenal axis and the circadian rhythm mechanism of cortisol secretion,explores the internal relationship between traditional Chinese medicine theory and modern physiology,and provides interdisciplinary theoretical support and innovative ideas for clinical treatment of perimenopause insomnia from the angle of“tonifying kidney and storing Yang”.
作者
董洪鑫
任路
DONG Hongxin;REN Lu(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《辽宁中医药大学学报》
2026年第2期131-135,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(82274665)。
关键词
肾为封藏之本
阳气
围绝经期失眠
下丘脑-垂体-肾上腺轴
发病机制
kidney as the root of sealed storage
Yang Qi
perimenopausal insomnia
hypothalamicpituitary-adrenal axis
pathogenesis
