| 引用本文:马晨曦1，冯淬灵2，郑佳昆1，冯枫2.王琦治疗139例失眠的临床经验[J].世界中医药,2022,(19):. |
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| 王琦治疗139例失眠的临床经验 |
| Wang Qi's Clinical Experience in Treating 139 Cases of Insomnia |
| 投稿时间：2021-12-21 |
| DOI：10.3969/j.issn.1673-7202.2022.19.022 |
| 中文关键词: 失眠 临床经验 交合安魂汤 血府逐瘀汤 交汇阴阳 引阳入阴 共病性失眠 王琦 |
| English Keywords:Insomnia Clinical experience Jiaohe Anhun Decoction Xuefu Zhuyu Decoction Yin and yang interchange Inducing yang into yin Comorbid insomnia @ Wang Qi |
| 基金项目:第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发2017-24号) |
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| 中文摘要: |
| 目的:总结国医大师王琦院士治疗失眠的临床经验。方法:选取2016年6月至2019年8月北京中医药大学国医堂王琦院士门诊治疗的失眠病例139例,拆分失眠表现,累计症状频次,分析证候、治法、方剂和用药特点。结果:总233诊次中,计入睡困难出现167次(71.7%);睡眠维持障碍185次(79.4%);睡眠质量下降26次(11.2%);总睡眠时间减少144次(61.8%)。伴随症状有疲乏、躯体症状、情志和认知症状、妇科、男科及其他症状等6类。常见证候:心肾不交49次(21.0%),心脾两虚39次(16.7%),瘀血内阻21次(9.0%),肝胃不和16次(6.9%),痰热内扰10次(4.3%),肝郁化火7次(3.0%),阴虚火旺6次(2.6%),心胆气虚4次(1.7%),其他81次(34.8%)。遣方用药:常用交合安魂汤、血府逐瘀汤,喜加用甘松、苦参、延胡索、萱草、龙骨、牡蛎、郁金、合欢皮、黄连、肉桂、麦冬、五味子、太子参、黄芪、丹参、刺五加等药。结论:王琦院士治疗失眠擅用交合安魂汤、血府逐瘀汤,交汇阴阳,调和营卫。 |
| English Summary: |
| To summarize the clinical experience of traditional Chinese medicine(TCM) veteran Academician Wang Qi in treating insomnia.Methods:A total of 139 insomnia patients treated by Wang Qi in Department of Traditional Chinese Medicine(Guoyitang) of Beijing University of Chinese Medicine from June 2016 to August 2019 were collected.Then the manifestations of insomnia were sorted out and their frequency was counted.The syndromes，treatment methods，prescriptions and medication characteristics were also analyzed.Results:In 233 cases of the 139 patients，167 cases(71.7%) had difficulty in falling asleep; 185(79.4%) felt sleep maintenance disorder; 26(11.2%) suffered from decreased sleep quality; 144(61.8%) complained decrease of total sleep time.There were six categories of accompanying symptoms，including fatigue，physical symptoms，mental and cognitive symptoms，gynecological disorders，andrological symptoms and others.The common syndromes were as follows：non-interaction between heart and kidney(ICD-11 SF6L，49 cases，21.0%)，deficiency of both heart and spleen(ICD-11 SF6J，39 cases，16.7%)，internal obstruction of static blood(ICD-11 SF01，21 cases，9.0%)，liver-stomach disharmony(ICD-11 SF5K，16 cases，6.9%)，phlegm-heat harassing internally(ICD-11 SF14，10 cases，4.3%)，liver depression transforming into fire(ICD-11 SF57，7 cases，3.0%)，yin deficiency with effulgent fire(ICD-11 SF50，6 cases，2.6%)，heart，gallbladder and qi deficiency(ICD-11 SF6H，4 cases，1.7%)，and others(81 cases，34.8%).The commonly used prescriptions included Jiaohe Anhun Decoction and Xuefu Zhuyu Decoction，which were often added with medicinal materials such as Radix et Rhizoma Nardostachyos，Radix Sophorae Flavescentis，Rhizoma Corydalis，Concha Ostreae，Radix Curcumae，Cortex Albiziae，Rhizoma Coptidis，Cortex Cinnamomi，Radix Ophiopogonis，Fructus Schisandrae Chinensis，Radix Pseudostellariae，Radix Astragali seu Hedysari，Radix Salviae Miltiorrhizae，and Radix et Caulis Acanthopanacis Senticosi.Conclusion:Academician Wang Qi usually treated insomnia with Jiaohe Anhun Decoction and Xuefu Zhuyu Decoction that could promote yin and yang interchange and harmonize nutrient and defensive aspects. |
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