从“阳不入阴”理论辨证阳虚型失眠治疗

AbstractInsomniarefers toteinabilitytoobtainnormal sleep，oftenmanifestedasdiffcultyfalingasleep，easilywakingup during sleep，diicultyreturning tosleepafter waking，ordificultymaintaining slep.Thesesymptomsaffect people'sdailylife， work，study，andhalthtovryingdegreesasaseepdisordersyndrome.InTraditionalCineseedicie（TCM），insomaisoften referred toas“insomnia”（不寐），“inability to liedown”（不得卧），or“failure toclosethe eyes”（目不瞑）.TCMtheory posits that its pathogenesis is“YANGfiling toenterYIN”（阳不人阴），withyangdeficiencypreventing entry intoyinbeingtheprimarysyndromediffrentiation type.FromtheperspectiveofTCMorgansyndroediferentiation，itismostlyrelatedtokidneyyang deficiency，spleenyangdeficiencyandheartyangdeficiency.TCMoldsthatyangqigradualldeclinesandcirculateswithificultyasageicreassAtnght，itsmovementisbructed，ngeringinanganduabletteryintussultingin“failueto close the eyes”.Thisaligns withmodernresearchonthepopulationafectedbyinsomnia.Moreover，withtheaceleratedpaceof moderlifestylechangesindietanddailyroutines，theincidenceofyang-deficiency-typeinsomiashowsayearlyincreasing trend.Historicallyostpysicansavetreatedisomniabydressngyindeiiencygm，orloodsasis，ftensinget ods to nourishyinesolvepegmormovestasiswithvaingefectiveness.Whenencounteringinsomniapaternssuchafloatingyangduetodeficiencyyangdeficiencywithwaterflooding，orideficiencywithbloodstasis，ifpractitionersstillployyinnourishing，phlegm-resolving，orstasis-removing methods，theymayinsteadconsumeyangqi，leading toprotractedandefractory insomnia.Fewhave treatedyang-deficiency-type insomniafromtheperspectiveof“YANGfailing toenter YIN".Inrealitybased ontheafectedpopulationandcharacteristicsofrefractoryinsomnia，yang-deficiency-typeinsomniacasesarequite numerous.Therefore，thispaperwillbeginwiththepathogenesisof“YANGfiling toenterYIN”toexplorethesyndromedifren tiation and treatment of yang-deficiency-type insomnia.

KeywordsInsomnia;；Sleepless；Yang deficiency;Etiologyand pathogenesis；Yang does not enter Yin；Warm kidneyand latent yang；Warm and tonify spleen yang；Nourishing Heart Yang

中图分类号：R256.23 文献标识码：B doi：10.3969/j.issn.2095-7130.2025.05.065

失眠作为全球性公共卫生问题，患病率逐年攀升，约 30% 的成人存在睡眠障碍，导致内分泌紊乱、认知功能下降及心脑血管等疾病的风险增加[1]。（剩余6024字）