真武汤加味治疗阳虚寒凝型顽固性失眠验案

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Modified Zhenwu Decoction in Treating Refractory Insomnia of Yang Deficiency and Cold Coagulation Type：A Case Report

WANGNan1，WANG Tian²，LIHuaian²

（ I North China University of Science and Technology，Tangshan O63oOo，China; 2 Qinhuangdao Hospital， Dongfang Hospital，Beijing University of Chinese Medicine，Qinhuangdao O66ooo，China）

AbstractRefractoryinsomnia，which intraditional Chinese medicine（TCM）isclasifiedunderthediseasecategoryof“unable to sleep，eyescannotcloseandrestlessess”，iscausedbyavarietyofcomplexfctors.Troughouthistory，anyphysiciashave explored itspathogenesisfromvariousperspectives，includingphlegm-heatdisturbingtheheart，bloodstasisblockingthechannels，deficiencyoftheheartandspleen，heartdeficiencywithfear，heart-kidneydisharmony，andliverfiredisturbingthe heart.However，withthemodernchangesinworklifestylesanddietaryhabits，thespleenandstomachbecomedamaged，subsequentlyimpairing kidneyyang.Thiscausesadeficiencyofyang energy，whichleads toaninternal excessofcold，resultingina stateof yangdeficiencyandcoldaccumulation.Thisconditiondisturbs thespirit，resultingininsomnia.Currently，thereisnostematicunderstandingortreatmentapproach forinsomniaofyangdeficiencyandcoldcoagulationtype.Byanalyzingtherelationshipbetween yin，yang，the splenand kidneys，andslep，andfocusingonthepathogenesisof“deficiencyof yang energyand internal coldaccumulation”，clinicaluseof modified Zhenwu Decoctionhasachievedgoodresults intreatingthistypeofisomnia.Twoclinicalcasereportsareprovidedasevidencetosupportthisaproach，aiming tooffernewinsightsforclinicaldiagnosis and treatment.

KeywordsZhenwu Decoction； Yang deficiencyandcold coagulation； Yin-Yang imbalance；Kidneyyangdeficiency；Zang fu viscera；Refractory insomnia； Inability to sleep；Case report

中图分类号：R256.23；R338.63 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.02.030

顽固性失眠，又叫慢性失眠[1]，主要临床表现为：入睡困难、维持睡眠困难、早醒或醒后不能恢复体力与精神[2]、醒后感到疲倦和注意力不集中，症状每周出现3次或更多次，持续6个月或更长时间[3]在中国，大约有 15% 的人群正在遭受失眠的困扰[4]，并且长期的失眠容易诱发或加重心脑血管疾病，如高血压、冠心病等[5]。（剩余5561字）