1. 上海中医药大学附属曙光医院,上海,200021
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蒋健. 郁证发微(十二)——郁证不寐论[J]. 上海中医药杂志, 2016,50(7):5-8.
JIANG Jian. Insomnia due to depression syndrome[J]. Shanghai Journal of Traditional Chinese Medicine, 2016,50(7):5-8.
不寐有多种病因病机,但最为多见的是受思虑、悒郁、忧愁、恼怒、惊恐等情志因素影响而发生,其病机主要与心、脾、肝、胆等脏腑有关。郁证不寐的情志病因分为“外感性情志病因”与“内生性情志病因”,前者是指受生活负性事件影响而发生的应激性情志变化,当内心恢复平静后,其不寐多可告愈;后者是指宿主的郁证性心理和人格特质及气郁质体质禀赋,对“外感性情志病因”的应激性更大,甚至即便无明显“外感性情志病因”刺激,亦可内生忧思悲恐惊,其不寐积年难愈。在多数情况下,寐佳则无郁,郁去则寐安。郁证不寐的治疗,可通过解郁疏泄以安神促寐,亦可通过安神促寐以舒肝怡心;解郁与促寐类药物,其药性相通。
There are various items of the etiology and pathogenesis of insomnia in TCM theory,in which over-thinking,depression,sadness,anger,panic and so on are considered as the key emotional factors to the occurrence of insomnia. As a main and common symptom of depression syndrome,dysfunctions of heart,spleen,liver and gallbladder play important role in the pathogenesis of insomnia.This paper divided the classifications of emotions into “the external emotional factors” and “the internal emotional factors”.The former refers to irritable emotional changes caused by negative events. When inner peace is retrieved,insomnia is almost cured. The latter refers to psychological characteristics of depression syndrome,personality traits and Qi-stagnation constitution of the individual.The one who has “the internal emotional factors” always shows susceptibility and irritability to those external emotional stimulations,and can behaves depression,sadness,anger,panic and refractory insomnia. In most cases,good night sleep relieves depression,while the disappearance of depression syndrome promotes better sleep. So in the treatment of insomnia due to depression syndrome,soothing the liver and relieving depression could tranquilize mind and promot sleep,and vice versa. Relieving depression and promoting sleep interact on each other.
郁证不寐情志病因分类解郁与促寐
depression syndromeinsomniaclassifications of emotionsrelieving depression and promoting sleep
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