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全生讲中医(16)----失眠的中医防治(8/10/2011)

失眠又称入睡和维持睡眠障碍(DlMS),为各种原因引起入睡困难、睡眠深度或频度过短、早醒及睡眠时间不足或质量差等,常见导致失眠的原因主要有环境原因、个体因素、躯体原因、精神因素、情绪因素等。
 
失眠是临床常见症证之一,虽不属于危重疾病,但常妨碍人们正常生活、工作、学习和生活质量,并能加重或诱发心悸、胸痹、眩晕、头痛、中风等病证。据报道,慢性失眠是一个重要的公共健康问题,10-15%的美国人受此困扰,每年发费数十亿美元治疗失眠。因此,寻找安全有效的治疗失眠的方法和方药,成为当今医学界的重要课题。
 
失眠中医称为不寐, 是由于心神失养或不安而引起经常不能获得正常睡眠为特征的一类病证。主要表现为睡眠时间、深度的不足以及不能消除疲劳、恢复体力与精力,轻者入睡困难,或寐而不酣,时寐时醒,或醒后不能再寐,重则彻夜不寐。由于睡眠时间的不足或睡眠不熟,醒后常见神疲乏力,头晕头痛,心悸健忘及心神不宁等。
 
根据中医辨证施治理论,失眠可分心肾不交、心阴虚、心脾两虚、肾阴虚及胃不和则夜不安常伴有多梦等多种类型。治疗失眠宜补益心脾、滋阴降火、疏肝泻热、养心安神等。
 
北京中医药大学名老中医程士德教授,全国百名名老中医之一,积70余年临床经验,对关节痹痛、咳嗽、胃脘痛、闭经、更年期综合症、不孕不育、失眠、抑郁等精神情志失调性疾病和过敏性疾病等疑难杂证有丰富的理论和经验。作者有幸跟随程老坐诊三年,今抄录当时一失眠病例如下:
 
31岁,有植物神经紊乱,失眠五年余。程老根据辩证,治以健脾益气,养心安神。药用:太子参,炒白术,,茯苓,陈皮,半夏,木香,,竹茹,白蔻,焦三仙,香橼皮 , 酸枣仁, 各10g, 唯炒山药20g,砂仁6g.
 
针灸治疗时取内关、神门、三阴交、安眠穴为基础方,根据辩证,对证用穴。每周治疗两次,12次为一个疗程。通常1 ~3次即可直折病势,安神定志。
 
Sleep (2011 Jun) 报道,具有失眠症状的抑郁证病人,接受针灸治疗1周和4周后, 失眠症状都明显改善。针灸结合中药治疗失眠,报道亦很多。
 
两首小方,对防治失眠有帮助。1. 莲子30克,百合15克,冰糖适量。将莲子、百合共煮成汤,加冰糖调味,临睡前服。尤适用于虚热烦躁失眠者。2.柏子仁10~15克,粳米50~100克,蜂蜜适量。将柏子仁去净皮壳杂质,捣烂,同粳米煮粥,待粥将熟时,加入蜂蜜,稍煮1~2沸即可食用。每日2次,2~3天为1个疗程。尤适用于失眠健忘者。
 
另外,若久罹神经衰弱,长期失眠患者,也可每日临睡前,轻轻按摩申脉、照海二穴,久而久之,定有裨益。
 
下期敬请关注全生讲中医 (17)—抑郁症的中医防治. 更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-919-9898, 301-340-7682约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850 (1个街区到Rockville地铁站,免费停车). 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902 (2分钟走到Forest Glen 地铁站).
 

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