Disease Cognition Insomnia Insomnia is a type of disease characterized by frequent inability to obtain normal sleep. The main manifestations are insufficient sleep time and depth. In mild cases, it is difficult to fall asleep, or sleeps but not deeply, wakes up from time to time, or cannot fall asleep again after waking up, and in severe cases, stays awake all night, which often affects people's normal work, life, study and healthy. Chinese name: insomnia English name: insomnia Other names: not sleeping, keeping eyes closed Related diseases: neurosis, menopausal syndrome, chronic indigestion, anemia, atherosclerosis and other diseases with insomnia as the main clinical manifestation Category: Traditional Chinese Medicine Main causes of disease: Improper diet, emotional disturbance, work-rest disorder, physical weakness after illness. Common symptoms: Insufficient sleep time and depth. In mild cases, difficulty falling asleep, or falling asleep but not soundly, waking up from time to time, or waking up from sleep. Insomnia is a type of disease characterized by frequent inability to obtain normal sleep. The main manifestations are insufficient sleep time and depth. In mild cases, it is difficult to fall asleep, or sleeps but not deeply, wakes up from time to time, or cannot fall asleep again after waking up, and in severe cases, stays awake all night, which often affects people's normal work, life, study and healthy. Historical evolution 1. Insomnia is called "not able to lie down" and "not able to close one's eyes" in the "Nei Jing". 2. "Suwen·Ni Tiao Lun" records that "" disharmony in the stomach results in restless sleep. ” 3. Treatise on Febrile Diseases and Synopsis of the Golden Chamber believe that its causes are divided into two categories: external infection and internal injury, and put forward the discussion of “consumption, exhaustion, restlessness and insomnia”. 4. The Complete Book of Jingyue summarizes it as evil , two types of innocent. 5. Li Zhongzi of the Ming Dynasty proposed: ""There are about five reasons for insomnia: one is Qi deficiency, one is Yin deficiency, one is phlegm stagnation, one is water stasis, and the other is stomach disharmony. " 6. Dai Yuanli's "Keys to Syndrome and Treatment" also puts forward the theory that "old people are insomnia due to yang deficiency". The relationship with the names of Western medicine diseases: neurosis, menopausal syndrome, chronic indigestion, anemia, atherosclerosis in Western medicine When insomnia is the main clinical manifestation, you can refer to the content of this article for syndrome differentiation and treatment. The pathogenesis of insomnia is mainly related to the liver, spleen and kidneys. The basic pathogenesis is the deficiency of yin and yin. Inability to accept yang means that the yang cannot enter the yin. The pathological nature has two aspects: liver stagnation transforming into fire, internal disturbance of phlegm and heat, and restlessness. Deficiency of the heart and spleen, deficiency of heart and gallbladder qi, disharmony of the heart and kidneys, and lack of nourishment of the mind and spirit. It is defined as deficiency, but long-term illness may manifest as a combination of deficiency and excess, or be caused by blood stasis. Diagnostic basis: 1. In mild cases, it is difficult to fall asleep or to wake up easily, and insomnia persists for more than 3 weeks after waking up. In severe cases, it is difficult to sleep all night. . 2. It is often accompanied by symptoms such as headache, dizziness, palpitations, forgetfulness, fatigue, restlessness, and dreaminess. 3. This disease is often accompanied by improper diet, emotional disturbance, fatigue, excessive thinking, and other symptoms. , physical weakness and other medical history. Symptoms of insomnia should be differentiated from temporary insomnia, physiological insomnia, and insomnia caused by other diseases. Insomnia is characterized by simple insomnia and persistent difficulty in sleeping. . Temporary insomnia caused by temporary mood changes or changes in living environment is not a morbid condition. As for the elderly who sleep less and wake up early, it is mostly a physiological condition. If insomnia is caused by other diseases, the relevant causes should be eliminated. . Key points of syndrome differentiation: The syndrome of deficiency is mostly due to deficiency of yin and blood, and lack of nourishment of the heart. The clinical characteristics are thin body, lackluster complexion, palpitations and forgetfulness. Irritability, bitter mouth and dry throat, constipation and red urine. The second diagnosis is the location of the disease. The disease is mainly caused by the lack of nourishment or restlessness of the mind, and is related to the liver, gallbladder, spleen, stomach and kidneys. , mostly caused by internal disturbance of liver-fire; stuffy epigastrium with greasy coating and insomnia, mostly caused by food in the stomach and internal organs, excessive phlegm and heat; upset and palpitation, dizziness, forgetfulness and insomnia, mostly caused by yin deficiency and excessive fire, heart and kidney disharmony; and complexion with a dull complexion. , Tiredness of limbs, fatigue and insomnia are mostly caused by spleen deficiency and lack of nourishment of mind and spirit; upset and insomnia, easily frightened by things, are mostly caused by deficiency of heart and gallbladder qi, etc. The treatment principle should be to replenish deficiency and reduce excess, and adjust the yin and yang of the internal organs. The excess is purged, such as soothing the liver, purging fire, clearing away phlegm and heat, and neutralizing the phlegm. The deficiency is supplemented, such as nourishing qi and blood, strengthening the spleen, liver, and kidneys, and calming the mind and calming the mind on the basis of purging excess and tonifying deficiency. Such as nourishing blood and calming the nerves, calming the nerves, calming the mind and calming the mind. Other treatments: 1. Apply 9g of Evodia Fructus to the acupoints, add an appropriate amount of rice vinegar, mash the medicine and mix it into a paste with vinegar, and apply it to the Yongquan point on the center of both feet. Remove it every hour. 2. Acupuncture therapy (1) Body acupuncture: Acupuncture at Shenmen and Sanyinjiao points can be used to add Xinshu, Jueyinshu, and Pishu for patients with heart and spleen deficiency; for patients with kidney deficiency, Xinshu and Shenshu can be added. , Taixi; if the liver fire is disturbed, add Ganshu, Jianshi, and Taichong; if the spleen and stomach are not harmonious, add Weishu and Zusanli. They are subcortical, sympathetic, heart, spleen, kidney, endocrine, and Shenmen. Select 2-3 points each time, use moderately strong massage, and leave the needle for 20 minutes. The prognosis of this disease is generally good. However, due to different conditions, the prognosis also varies. For those with a short course of disease and simple condition, the treatment will be effective quickly, but for those with a long course of disease and complicated condition, the treatment will not be effective quickly. If the cause of the disease is not eliminated or treated improperly, the condition may become more complicated and treatment becomes more difficult. Prevention and care 1. This disease is a psychopathy. Paying attention to mental regulation and paying attention to sleep hygiene has practical preventive significance for insomnia patients. Actively make psychological and emotional adjustments, overcome excessive tension, excitement, anxiety, depression, panic, anger and other negative emotions, keep joy and anger in check, maintain a comfortable mind, try to treat it with a relaxed and let nature take its course, and sleep will be better Can sleep better.
2. In terms of sleep hygiene, help patients establish a regular work and rest system and engage in appropriate physical activities or physical fitness activities. Develop good sleeping habits. Dinner should be light and not overly full. Strong tea, coffee and smoking should be avoided. Avoid engaging in stressful and exciting activities before going to bed. Develop the habit of going to bed on a regular basis. In addition, we should pay attention to the tranquility of the sleeping environment. The bed should be comfortable, the light in the bedroom should be soft, reduce noise, and remove various external factors that may affect sleep. Clinical preparations 1. Three essentials should be mastered in treating insomnia: ① Pay attention to adjusting the balance of yin and yang in the organs, qi, blood. For example, to nourish the heart and spleen, a small amount of medicine should be used to invigorate the spleen and nourish the spleen to prevent obstruction of the spleen. To nourish the heart and kidneys, cinnamon should be used in a light amount to replenish qi and calm convulsions. To strengthen the spleen, it is necessary to use medicines that nourish yin with caution. ; Soothe the liver and purge the fire, pay attention to nourishing the blood and softening the liver, so as to embody the meaning of ""The body's yin uses yang". ""Supply the deficiency, purge the excess, adjust the deficiency and excess", so as to harmonize the qi and blood, yin calms the yang secret. ② Emphasis On the basis of syndrome differentiation and treatment, soothing and calming methods are used, including nourishing blood and calming the mind, clearing the heart and calming the mind, nourishing yin and calming the mind, replenishing qi and calming the mind, calming the nerves and calming the mind, etc. ③ Pay attention to the effect of mental treatment. Eliminate worries and tension, and maintain a comfortable mind. 2. Application of the method of promoting blood circulation and removing blood stasis: For patients with long-term stubborn insomnia, poor clinical effect of multiple treatments, irritability, dark tongue, and petechiae, according to the ancient saying " " From the perspective of "stubborn diseases with multiple blood stasis", it can be treated from the perspective of blood stasis, and Xuefu Zhuyu Decoction is selected. Medicinal peach kernel, safflower, Chuanxiong, angelica, red peony root, and salvia miltiorrhiza are used to activate blood circulation and remove blood stasis. Bupleurum and Citrus aurantium are used to regulate qi and soothe the liver. Dragon and Lulutong activate the collaterals and calm the mind, and the Radix Rehmanniae nourishes the yin and clears the heart. It activates blood circulation and removes blood stasis, unblocks the collaterals and calms the mind. Literature summary 1. "Su Wen Ni Tiao Lun": ""Yangming is also the stomach pulse. , the stomach is the sea of ??the six internal organs, and its Qi also flows downwards, and the Yangming is reversed and cannot follow its path, so it is impossible to lie down. The lower meridian says, "If the stomach is not in harmony, then you will be restless when lying down." This is what it means. " 2. "Jingyue Quanshu·Insomnia": ""Such as phlegm, such as fire, such as cold air and water vapor, such as insomnia caused by anger due to eating and drinking, these are all caused by internal evil stagnation and rebellion..." Those who are tired of thinking, frightened, worried and doubtful, and often insomnia because of nothing else, always belong to the true syndrome. Insufficient blood, yin and yang are not interoperable, and the spirit is restless in the room and ears." "Jingyue Complete Book. Insomnia" Quoting Xu Donggao, he said: "" Phlegm-fire disturbs the mind, causing restlessness, excessive thinking, and burning fire and phlegm stagnation, resulting in insomnia in many cases. Some people cannot sleep due to insufficient kidney water, true yin does not rise, and heart yang is only excessive. ...For those whose body Qi is excessive and sometimes caused by phlegm-fire and cannot sleep, it is advisable to use Rolling Tan Pills first, followed by Anshen Pills to clear the heart and cool the diaphragm. If the body is weak, either due to overwork or illness, this is insufficient, so it is better to use nourishing blood and calming the nerves. Anyone who cannot sleep after illness or after giving birth is due to qi deficiency and insufficient heart and spleen. Although there is phlegm fire, it should not be attacked too much. The treatment should still be based on nourishment, or supplemented with medicine that clears phlegm and lowers fire. " 3. "Treatment of Similar Syndrome: Insomnia": " "When Yang Qi is quiet and quiet, it means sleepiness; when Yin Qi is quiet and moves on its own, it is insomnia. If there is insomnia, the disease is that Yang does not interact with Yin." ” 4. "Lingshu·Dahuolun": ""Huangdi said: People are forgetful, what is the cause of Qi? Qibo said: Insufficient upper Qi and excess lower Qi, the intestines and stomach are strong but the heart and lungs are deficient. If the Qi is deficient, the Yingwei will remain. , It takes a long time to catch up with time, so it is easy to forget. " 5. "Re-editing of Yan's prescriptions for rejuvenating life. The gate of fright, palpitation, distress, and forgetfulness": " "Forgetful people often like to forget." The spleen controls thoughts and thoughts, and the heart also controls thoughts. Excessive thinking will lead to indistinct thoughts and ineffectiveness in the palace, making people forgetful. The way to treat it is to manage the heart and spleen, make the mind clear and calm, and think about it. " 6. "Danxi Xinfa·Forgetfulness": ""Forgetfulness is often associated with lack of energy and phlegm." Dai Yun: For those who are forgetful, things have a beginning but no end, and they don’t know the beginning or end of a conversation. This is the name of the disease, and it is not compared with the natural stupidity and ignorance of people. ...This syndrome is caused by excessive worry, which damages the heart cells, causing the mind to be unclear and forgetful about things. This is caused by excessive thinking and the disease is in the heart and spleen. To treat it with Guipi Decoction, you must manage the heart and spleen at the same time, so that the mind is calm and the mind is calm, and the syndrome will be cured by itself. "Medical Record Reading Medical Record No. 1, 33 years old, said that he has been suffering from insomnia for a long time. He often suffers from heart palpitations, hesitation and panic. The diagnosis showed that the six pulses are thin and wet, and the left pulse is even weaker. This is caused by excessive exercise of the mind, which damages the heart yang and affects the five internal organs. All are weak. It is recommended to add two qian of turtle and deer elixir to supplement it. Three qian each of Bairen, Guangjuhong, one qian and five cents of calamus, one qian of powdered grass, one qian of longan, three red dates, three slices of ginger, and three slices of ginger. It is advisable to take one pig heart every day, and one or two raw jujube kernels, stew them in water until soft, and take them to bed in the evening. Then remove the jujube seeds and drink it with the soup. Second diagnosis: Taking 4 doses of the above medicine is quite good. The dizziness, insomnia, and palpitation are all reduced. If the Zuoguan pulse is weak and stringy, do not worry too much to avoid disturbing the liver yang. Be careful. Make pills by adding or subtracting from the original recipe, and take it easy to supplement it. One or two pieces of Poria Shen, one or two astragalus, one or two pieces of tortoise shell glue, one or two pieces of calcined dragon teeth, one or two pieces of medicine, grind it into fine powder, dissolve it with tortoise glue, add refined honey to make pills, for big Wuzi, take three qian in the morning and evening with boiled water. (Editor-in-Chief Zhang Wenkang. Series of Hundreds of Traditional Chinese Medicine Clinicians in China·Xu Shufu. China Traditional Chinese Medicine Publishing House. 2001) Case No. 2, in his prime, the patient was worried and exhausted, which over time led to insomnia, and he was often unable to sleep all night long. Eyes. Since the beginning of summer this year, my insomnia has worsened. I have been unable to fall asleep for three nights after treatment. My clothes are not hot, my food is not tasty... My face is white, but I am full of energy. There are faint red threads, the pulse is evenly long at both ends, and there are blue lines on the edge of the tongue.
The patient was sluggish due to long-term thoughts, and Qi and blood burst out, causing blood stasis. If the blood stasis was not removed, he would end up restless in sleep, so he was treated with Xuefu Zhuyu Decoction. Peach kernel 12g, safflower 9g, angelica 9g, Chuanxiong 9g, Achyranthes achyranthes 9g, Panax notoginseng 9g, Dashengchi 9g Bupleurum 9g, Jingchi peony root 9g, Fried Citrus aurantium 9g, Zhigancao 3g. Second diagnosis: In the next two months, I came back for treatment, and I was told that I would be here in ten days. I suffer from insomnia again, but not as bad as the last time... Both levels are still intact. The evidence is still valid, because there are signs of inflammation caused by liver-fire such as headache, red eyes, bloating in the flanks, etc. Just as Ke Yunbo said: "" When liver-fire is strong, the orifices will go up and you will not be able to sleep. "Switch to Gentian Xiegan Decoction. Scutellaria 9g, Gentian 4.5g, Rehmannia 9g, Alisma 9g, Plantago 9g, Raw licorice 3g, Bupleurum 6g, Gardenia 9g, Angelica 6g, Akebia 9g. *** Take 5 doses at night. Sleep is safe, and symptoms of inflammation caused by liver fire are also eliminated. (Edited by Yu Ying'ao et al. Selected Cases of Modern Famous Traditional Chinese Medicine·Mr. Fan Xianhu's Insomnia Case. People's Health Publishing House. 1983) Statement: The article is from the Chinese Medical Information Inquiry Platform. Editor: Asarum Mei. : Brother Chong Disclaimer: The above content comes from the Internet, and the copyright belongs to the original author. If there is any infringement of your original copyright, please inform us and we will delete the relevant content as soon as possible.