With the fast-paced life of social information and the pressure of life and work, the number of insomnia patients has increased, and more and more people are currently suffering from difficulty falling asleep, light sleep, and more dreams. Modern medicine believes that there are many causes of insomnia, which can be roughly divided into external and internal causes.
External factors are mainly the stimulation of the body and brain from the outside world, including work pressure, life pressure, emotional pressure and so on. Internal causes are caused by their own reasons, including post-operative stress trauma, adverse drug reactions, disease accompanying symptoms, mental illness, etc. Whether it is internal or external, prolonged insomnia will inevitably have a huge impact on the human body.
Traditional Chinese medicine believes that in modern life, insomnia is mostly due to overeating, excessive drinking, high stress, and irregular life and rest. , lead to the damage of the spleen and stomach transport and transformation function, the evil heat is endogenous, the heat gathers and produces phlegm, the phlegm-heat interlocks, moves up with the qi, blocks the heart orifice, causes restlessness or phlegm-heat evil blocks the qi machine, and the qi machine rises and falls. , yang does not enter yin which leads to insomnia. Therefore, “phlegm” has gradually become an important factor and key pathogenesis of insomnia in today’s society.
Difficulty falling asleep because of phlegm
Sputum is caused by too much phlegm These internal and external factors act on the human body, damage the functions of the viscera, cause water and fluid metabolism disorders, and stop body fluids from gathering. After phlegm is formed, different pathological properties will be seen due to different physical qualities. If it is a body with yin deficiency and internal heat, or due to exogenous pathogenic heat, spicy food and other factors, phlegm stagnation is easy to turn heat into phlegm hot. “Jingyue Quanshu·Insomnia” quoted Xu Donggao as saying: “There are many people who are disturbed by phlegm and fire, restless in their minds, over-considered, and insomnia caused by burning phlegm and stagnation.”
As a pathogenic factor, phlegm-heat destroys the balance and coordination of yin and yang in the human body, makes Yang qi float outside, “can’t enter yin”, disturbs the mind and prevents sleep. It can be seen that insomnia caused by phlegm-heat must have pathological factors of phlegm-heat and restlessness.
Le Qisheng TCM team believes that with the increasing pressure of study and work, people are often troubled by various tension and anxiety. Emotional factors have become an important cause of insomnia. The pathogenesis of the seven emotions can directly damage the viscera and affect the circulation of qi and blood. Among them, liver qi stagnation is the most common. If the emotions are stagnant and the anger hurts the liver, the liver will lose its stagnation and release, and the qi will turn into fire for a long time. In addition, the liver will lose its balance, and the qi will not be able to release Jin, and it will gather into phlegm, and the phlegm, Qi and fire are intertwined, disturbing the mind, and the symptoms of insomnia can be seen immediately.
Furthermore, with the acceleration of the pace of life, many people eat without restraint and regularity, and frequent hunger and satiety disorders. “The fat person makes people hot, and the sweet person makes people full.” Improper diet, damage to the spleen and stomach, loss of appetite and transportation, it is easy to produce phlegm. Or old age, chronic illness, lack of spleen movement, and the essence is not normalized, and it can also lead to phlegm turbidity. The evil of phlegm turbidity disturbs the heart along the Yangming stomach and collaterals. If the mind cannot stay at home, sleep will be disturbed. As Qin Jingming said in “Treatment of Diseases and Pulses, Volume 3, No Lying Due to Internal Injury”: “The reason why the stomach is not in harmony and cannot lie down is that the stomach is strong and eats more, the spleen is weak and cannot be transported and transformed, the stomach is stagnant, and the drink becomes phlegm. The qi in the Zhongwan is suffocated and uncomfortable, and the pulse of Yangming is reversed and cannot be descended, and the symptom of not being able to lie down is caused.”
Thirdly, phlegm is a pathological product formed by water and fluid metabolism disorders. Once formed, it has the characteristics of heavy turbidity and viscosity, and it hides with Qi. In the orifices of the mind, the first symptom of insomnia is often characterized by a long course of disease and easy recurrence. Patients with long-term insomnia can cause deficiency of viscera, qi and blood. If they cannot nourish the heart due to insufficient nourishment and blood, the syndrome of deficiency of both the heart and spleen will be caused; If the kidney water is insufficient, they cannot Those who benefit from the heart will often have the evidence that the heart and kidneys do not communicate; if the heart and courage are deficient, those who are indecisive in planning and thinking will often manifest as symptoms of being easily frightened when encountering things, irritability and insomnia.
Treatment according to different syndromes, resolving phlegm and dissipating stagnation, and calming the nerves
Clinical In the treatment of insomnia, phlegm is always the core pathogenesis. The Le Qisheng TCM team adheres to the principle of “prioritizing the cause and subduing the owner”, and treats insomnia from the perspective of phlegm. Reduce cuts. Banxia Houpu Decoction is from “The Synopsis of the Golden Chamber: Women’s Miscellaneous Diseases and Pulse Syndrome Treatment”, which states that it is mainly used for “women’s throat if there is burning sputum”, which is caused by stagnation of seven emotions and stagnation of phlegm. Le Qisheng TCM team believes that the legislation of this prescription is exactly in line with the etiology and pathogenesis of insomnia. In the prescription, Pinellia and Magnolia are the king drugs, and Pinellia is especially good for dissolving phlegm and dispersing knots.
If the mood is uneasy, the phlegm and qi are blocked, and the fire is transformed over time, then add gentian grass, gardenia, coptis, etc. Stones, pumice stones, etc. to clear away phlegm and heat, Fushen, Polygala, acacia flowers, etc. to calm the mind and soothe the mind. Zi, etc. to eliminate food and induce stagnation, Fu Shen, Yuanzhi, Acacia flowers, etc. to resolve phlegm and calm the spirit; if the course of the disease is prolonged, the phlegm is turbid, and the righteousness is insufficient, if there is also a syndrome of deficiency of the heart and spleen, add Astragalus, Codonopsis, Atractylodes, angelica, longan meat and other nourishing heart and spleen.
Medical case analysis
A patient, female, 72 years old, was first diagnosed on April 22, 2019. Chief Complaint: Insomnia for more than 1 year, aggravated for 1 month. History of present illness: The patient had insomnia 1 year ago without obvious incentives. He had taken sleeping pills by himself (the specific name and dosage of the drug are unknown), but the effect was not good. In the past month, the symptoms have worsened, and the current symptoms are difficult to fall asleep. After falling asleep, it is easy to wake up, and it is difficult to fall back to sleep after waking up. In the morning, symptoms such as fatigue, dizziness, dizziness, and a sticky mouth are obvious. The patient complained of nervousness, sighing, timidity and fright, accompanied by poor appetite, once a day, soft, sticky stools, usually obvious cold, pale tongue, fat and greasy coating, and thin pulse.
Western medicine diagnosis: insomnia; Chinese medicine diagnosis: insomnia (phlegm-qi obstruction and heart and gallbladder deficiency syndrome). Add or subtract to Banxia Houpu Decoction: French Pinellia, Magnolia officinalis, Perilla leaves, Poria, Fushen, ginger, ginseng, keel (fried first), oyster (fried first), jujube seed, acacia flower, Bupleurum , Mint (after the next), Ophiopogon japonicus, Schisandra. 7 doses, decocted in water, 1 dose a day, taken at noon and before going to bed.
Second diagnosis: The patient reported that it was easy to fall asleep after taking the drug, and although it was easy to wake up during sleep, he could still fall asleep again until dawn after waking up, and his mental state in the morning was significantly improved compared with before. Following the preparation of the previous recipe, for 7 doses, the decoction method is the same as before. After the addition and subtraction of this prescription, it was used for 4 weeks, and it was effective. Instruct the patient to pay attention to the mental adjustment to keep the mood comfortable. Follow-up so far, no offense.
In addition, insomnia is a typical physical and mental disease, especially chronic insomnia that recurs. Patients are often accompanied by certain anxiety and depression. Therefore, in the process of taking medication, we must help patients to understand correctly. In addition, many insomniacs are caused by poor work and rest rules such as staying up late, so it is also very important to establish a regular work and rest time. If phlegm is endogenous due to deficiency of spleen and stomach or improper diet, adjusting eating habits and establishing a reasonable diet structure will also help to consolidate the curative effect.