| 引用本文: |
左佳鹏, 陈海燕, 许信韬, 张莹, 彭小宸, 杨超群, 吕小亮.基于“主客交-络病”理论探讨顽固性失眠的病机及辨治[J].湖南中医药大学学报,2026,46(8):1693-1698[点击复制] |
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| 基于“主客交-络病”理论探讨顽固性失眠的病机及辨治 |
| 左佳鹏,陈海燕,许信韬,张莹,彭小宸,杨超群,吕小亮 |
| (暨南大学中医学院, 广东 广州 510632;暨南大学附属江门市中医院, 广东 江门 529000) |
| 摘要: |
| 顽固性失眠是临床常见的慢性睡眠障碍，以迁延难愈、反复发作、西药依赖率高为特点，历代医家多将其归为“目不瞑”“不得卧”范畴，其病机与“主客交-络病”理论高度契合。顽固性失眠分为髓海空虚、痰气郁结、瘀毒内蕴三期，病理演变呈“虚-郁-瘀”三阶递进。基于此，临证以“以通为用、通补相兼”为原则，按病机阶段予以扶主荣络、化痰通络、逐瘀解毒之法，为中医药辨治顽固性失眠提供新思路。 |
| 关键词: 顽固性失眠|主客交|络病|辨证论治|病机 |
| DOI：10.3969/j.issn.1674-070X.2026.08.023 |
| 投稿时间：2026-03-26 |
| 基金项目:广东省中医药局科研项目（20261461）。 |
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| Pathogenesis and pattern differentiation and treatment of refractory insomnia based on the "host-guest intermingling and collateral disease" theory |
| ZUO Jiapeng, CHEN Haiyan, XU Xintao, ZHANG Ying, PENG Xiaochen, YANG Chaoqun, LYU Xiaoliang |
| (School of Chinese Medicine, Jinan University, Guangzhou, Guangdong 510632, China;Jiangmen Traditional Chinese Medicine Hospital Affiliated to Jinan University, Jiangmen, Guangdong 529000, China) |
| Abstract: |
| Refractory insomnia is a prevalent chronic sleep disorder in clinical practice, marked by a protracted course, frequent recurrence, and a high reliance on Western pharmacotherapy. Physicians throughout the ages categorized this condition mainly under the TCM disease terms "mu bu ming" and "bu de wo", both denoting inability to sleep. Its pathogenesis aligns well with the "host-guest intermingling and collateral disease" theory. Refractory insomnia can be divided into three pathological stages: deficiency of the sea of marrow, phlegm-qi stagnation, and internal retention of stasis-toxin, following a three-step progressive pathological progression of "deficiency-stagnation-stasis." Accordingly, the therapeutic principle of "unblocking as the primary approach, combined with tonifying" is adopted. Matching these three pathological stages, therapeutic strategies comprise reinforcing the host and enriching the collaterals, resolving phlegm and unblocking the collaterals, as well as dispelling stasis and eliminating toxin. This framework offers novel insights for the pattern differentiation and treatment of refractory insomnia in Chinese medicine. |
| Key words: refractory insomnia|host-guest intermingling|collateral disease|treatment based on pattern identification|pathogenesis |
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