阿片类戒断综合征继发顽固性失眠的伤寒六经辨证特色探讨.doc

阿片类戒断综合征继发顽固性失眠的伤寒六经辨证特色探讨 李巨奇，李卫青，马全庆，廖文生，禤少敏，夏洪涛，赖伟娇 广东省深圳市第五人民医院（罗湖医院）中医科 广东 深圳 518001 【摘要】目的：从六经辨证角度出发，探讨阿片类戒断综合征继发顽固性失眠（IISS）的辨治特色。方法：运用仲景六经辨证方法，结合营卫学说、胃气学说、神明学说。结果：“营卫不和，阴阳失调”与“胃气不和，枢机不利”是IISS的主要病机；和法、通法是IISS六经论治的主要方法；“大建中州，顾护后天”、“益阴扶阳，三阴并治”是IISS六经辨治的关键和根本。结论：从六经辨治IISS，发病初期，辨在三阳经；发病后期，辨在三阴经。以和法、通法为，重视枢机，三阴并重对于改善睡眠增强正气，缓解阿片类药物戒断综合征症状，临床效果有重要的指导意义，体现了仲景学说全程性、多维度的辨治特色。 【关键词】阿片类戒断综合征；顽固性失眠；伤寒论；六经辨证；中医药研究 Characteristic discussion on intractable insomnia secondary to opioid drug withdrawal syndrome used with method of Six-channel differentiation and treatment Li juqi, Li weiqing, Ma quanqing, Liao Wensheng, Xuan shaoming, Xia hongtao, Lai weijiao Shenzhen municipal fifth peoples hospital(luohu hospital), TCM department, 518001, Shenzhen, Guangdong 【Abstract】Objective: To discuss IISS characteristics of differentiation and treatment from the perspective of six-channel differentiation. Methods: Used Zhang zhongjings method of six-channel differentiation and treatment, Combined with Ying Wei theory,Wei Qi theory and Sheng Ming theory. Results: The main pathogenesis of IISS were shown as disturbance of Ying and Wei, Yin and Yang, Wei Qi and Shu Ji; He Fa and Tong Fa were the main therapy methods; To build Zhong Zhou, protect Hou Tian, supplement Yin and help Yang, at the same time paid attention to Tai Yin, Shao Yin, Jue Yin meridians, which were the key and basic of six-channel differentiation and treatment on IISS. Conclusion: To discuss IISS from the six-channel syndrome differentiation, distinguished the three Yang meridians in the early period but the three Yin meridians in the late period, attached great therapy importance to the Shu Ji, three Yin meridians，which could have important guiding significance to improve sleep and other clinical results, enhance the vital qi, relieve symptoms, at the same time, embody the entire and multi-dimensional characteristics of the six-channel differentiation and treatment. 【Key words】Opioid drug withdrawal syndrome（ODWS）