【作者】 张起华；

【导师】 过伟峰；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：本研究旨在探讨失眠从心胆气虚论治的理论依据,结合中医体质学说阐述本病证的病因病机、辨证思路、治疗要点和方药应用。通过8则验案分析,进一步探讨“从心胆气虚论治失眠”的原理与方法,为失眠证治提供有益参考。方法：通过文献回顾、理论研究,总结归纳失眠心胆气虚证的证治规律,并与临床验案相互印证。文献研究较为系统地回顾总结了古今中外有关失眠的基础理论和临床治疗进展。认为失眠的西医基础理论研究日趋深化,成果辈出,但药物治疗效果尚有争议,尤其是耐药性和反跳现象亟待解决,中医治疗失眠有悠久历史,形成了较为系统完整的理论体系,流派纷呈。理论研究着重探讨失眠从心胆气虚论治的依据。分别从文献依据、理论依据、临床流行病的调查数据进行阐发。结合现代体质学说,探讨失眠心胆气虚与体质因素的内在联系。研究探讨本病证形成的机理及其与其它证候的兼夹复合规律。进而总结心胆气虚型失眠的辨识要点、治疗思想和方药应用规律。结果：为了论证失眠从心胆气虚治疗的临床疗效,介绍了导师临床验案8则,均以失眠为主症,同时兼有健忘、早泄、抑郁、焦虑、嗜睡、更年期综合征等病证,均采用益气镇惊,安神定志为主法,取得较好疗效。通过验案分析,丰富、充实了失眠从心胆气虚论治的理论体系。结论：本文通过文献回顾、理论研究与临床验案分析,总结归纳出气虚体质是失眠心胆气虚证形成的内在基础,决定该病证的发病与转归,结合脏腑病机辨证理论,使失眠从心胆气虚治疗更具有针对性,更能体现治病求本的治疗理念。根据子母同治理论,采用益气镇惊、安神定志为基本治则,治疗方药首选安神定志丸、启阳娱心丹加减灵活化裁,疗效满意,显示中医药治疗失眠具有良好的应用前景。更多还原

【Abstract】 Objective:This study aimed at exploring insomnia from Qi deficiencies of the heart and gall, combining the theory of Chinese medicine physical doctrine on the disease card in the cause of etiology and pathogenesis, ideas of syndrome differentiation, treatment elements and drug use. Analyzing 8 typical cases inspection, further explore "treat insomnia from Qi deficiencies of the heart and gall" principle and method for insomnia permit analysis provide a useful reference.Method:Literature more systematic review and sum up the modern and ancient times to insomnia in the basic theory and clinical treatment. The insomnia in western medicine basic theoretical researches are deep, and the results numbers, but the treatment of the results still controversial, particularly in the resistance and anti-jump need to be resolved, the Chinese medicine treatment of insomnia history, a more systematic complete theoretical system, schools and intricate.Theoretical study focused on insomnia from Qi deficiencies of the heart and gall on the basis. This research explains the evidences from the literature on the basis, theory, clinical epidemiological survey data. Combined with modern physical doctrine, explore insomnia Qi deficiencies of the heart and gall and physiological factors in. Study on the formation of a certificate of the disease and its aircraft and other evidence and waiting for the Law of compound, to sum up Qi deficiencies of the heart and gall virtual type insomnia, identify elements, treatment and ideological and drug use laws.Result:In order to demonstrate insomnia from Qi deficiencies of the heart and gall of the clinical treatment virtual gas treatment on the Clinical Examination instructors are cases of disease mainly to insomnia, with amnesia, premature ejaculation, depression, drowsiness, anxiety, of diseases such as integrated recruitment, use replenishing Qi,soothing the heart and calming the mind,getting the better treatment. Through a test case analysis, enriched the sleep from Qi deficiencies of the heart and gall virtual theory the theoretical system.Conclusion:This text checks the case analysis through the cultural heritage review, the theories research and clinic, tallying up to induce to give vent to anger falsely the physical endowment is the inside foundation that suffers from insomnia the courage debility certificate formation, deciding the outbreak of that disease certificate and turning to return, combining the dialectical theories of the internal organs disease machine, making to suffer from insomnia to cure to even have sex of aim at from the courage debility, more ability the body cure illness now beg originally of treatment principle. According to Chinese medical theory, the adoption benefit spirit town is surprised and tranquilizes the nerves to settle the ambition for basic cure then, cure the square medicine head to choose to tranquilize the nerves to settle the ambition pill, qi yang yu xin dan to add and subtract vivid turn to cut, the curative effect be satisfied with, showing the Chinese medicine treatment suffers from insomnia to have the good applied foreground.更多还原