| Person’s life, at least 1/3 of the time is in sleep. Insomnia is a serious threat to human health 。 Insomnia is a kind of diseases that often can not have normal sleep. The clinical manifestations include the shortage of hours of sleep and deepness of sleep, and cannot get recovery of physical strength and vigour after sleeping. The milder ones have the Clinical manifestations of difficulty falling asleep, or cannot have deep sleep, be awake now and again during sleep, or cannot fall asleep again after awaking at night. The serious patients cannot fall asleep all night long. Insomnia is one of the most common diseases of TCM internal medicine outpatient service. Insomnia has the high incidence in recent years. About 55.3% said they had to resort to various methods to go to sleep. China’s first report on people’s sleep quality released recently in Beijing showed that our citizens don’t sleep well enough given the sleep quality index being only at a passable level, while half of the respondents admitted work pressure have affected their sleep patterns.The main western medicine treatment is taking hypnotics, and it has a certain curative effect. But hypnotics also have toxic and side-effects, such as drug tolerance, drug accumulation, drug dependence abstinence reaction, influences on cognition and memory, and so on. Chinese Traditional Medicine (TCM) has its own unique theory system on sleep. Accumulating plenty of experiences during thousands of years, curative effects are reliable, and side effects are slight. Professor Zhu Jiangui has gone in for theory and clinic research on sleep disorders for a long term. He has cured a lot of insomnia patients, and has formed his own clinical experience. Author of this text overall and systematically arranges and study Professor Zhu Jiangui’s clinical experiences of curing insomnia using thoughts of regulating qi and resolving phlegm, discussing methods and pathways of TCM treating insomnia by using thoughts of regulating qi and resolving phlegm. And summarizing effective methods, prescriptions and drugs or herbs of Professor Zhu Jiangui’s experiences of curing insomnia by using thoughts of regulating qi and resolving phlegm. And thus can help raising the clinical level of treating insomnia by TCM.First part1.Research progress of TCM treatments to insomniaThis part summarizes the research work done by TCM experts inside China in recent years. It contains several parts, TCM realization to etiological factor and pathogenesis of insomnia, TCM Zheng differentiation-treatment to insomnia external therapy to insomnia. According to TCM realization to etiological factor and pathogenesis of insomnia, there are a lot of reasons for insomnia, such as over thinking and over fatigue, impairment of Heart and Spleen, heart yang and kidney yin inordinate, asthenic yin causing excessive pyrexia, disorder of the stomach, and so on, can affect heart-spirit and lead to insomnia. Insomnia is mainly related to Spleen, Liver, Heart and Kidney. From pathology products, it’s mainly related to phlegm heat harassing and stagnant blood. Totally, they can be analyzed into 2 kinds from asthenia and sthenia. According to zheng differentiation-treatment, treatments often get quite good effects by curing Liver and Gall, Qi and phlegm, asthenic yin causing excessive pyrexia, and Heart-Spleen deficiency.2. Clinical studies of treating insomnia with harmonizing Qi and phlegm. It is the beginning of "treating insomnia with regulating qi and resolving phlegm". Later ancient TCM physicians expanded this theory a lot. This text try to deeply discusses this view by two ways:One is discusses about relations between sleep and qi and phlegm in Huangdi’s Internal Classic, the other is how the later ancient TCM physicians expanded the theory about "treating insomnia with Regulating qi and resolving phlegm". From the point of view about etiology and pathogenesis, this text tries to put such ideas in order:insomnia caused by Qi and phlegm Qi deficiency; insomnia caused by Stomach Qi ascending counterflow and disharmony between nutrient and defensive Qi; insomnia caused by food piled up in Stomach and Intestine, and disturbance of Qi movement; phlegm heat harassing Heart. This can help treating insomnia through Qi and phlegm by zheng differentiation-treatment more clearly.Second partProfessor Zhu Jiangui learned from famous Chinese medicine physician Lu Zhizheng. He inherits their academic thoughts and clinical experiences on regulating qi and resolving phlegm. He emphasizes harmonizing Qi and phlegm during his work. He treats insomnia by harmonizing Qi and phlegm, accumulating plenty of clinical experiences. He belongs to the Qi and phlegm System in present age.The following part introduces Professor Zhu Jiangui’s thoughts about insomnia. First, his realization to theories of insomnia it includes theories about sleep, yin-yang sleep theory, nutrient and defensive Qi sleep theory, spirit mastering sleep theory. Chinese overall sleep concept opens up a broad field of study. There are a lot of methods by TCM for the overall adjustment and treatment of sleep disorders, which has opened up a broad prospect for the modern treatment of sleep disorders.According to the theory of traditional Chinese medicine on sleep, sleep is the body whole life form. Sleep is closely related to Yin and Yang, Qi and blood, zang-fu organs. The good balance of yin and yang, sufficiency and smooth transferof qi-xue, coordination and unification of zang-fu, the gentlenss and smoothness of gas lift and down, peaces of five organs, are the necessary conditions of sleep. Insomnia is a plurality of the mechanism. If just one of the relationships of yin and yang, qi and xue, and zang and fu, are all imbalance, it will happen. So Professor Zhu Jiangui thinks that five-zang and six-fu all can make people insomnia. Discussing the main pathogenesis of zang and fu functional disorders causing, giving the thought that treating by Heart, heeds I10U2’lshlIlg Heal, clearing away Heart fire deoppilation Heal-t, and calming Heart. Treating insomnia causing by Lung, needs invigorating Lung, nourishing Lung, facilitating Lung, keep nutrient and defensive Qi in balance. Treating lby LIVeI’ and Gall, needs invigorating Liver, nourishing Liver, facilitating Liver, clearing away Liver-tire, warming Gall, et al. Treating insomnia causing by Qi and phlegm, commonly needs Regulating qi and resolving phlegm, invigorating Spleen, regulating stomach, et al, to get the body back to health. Treating insomnia causing by Kidney, commonly needs invigorating Kidney, clearing away Kidney-fire, coordinating Heaut-Kidney, et al. Thus, Professor Zhu Jiangui suggests that Stomachand Spleen disharmony leading to restless sleep. It wsas demonstrated the relationship between qi and phlegm and sleep. Qi and phlegm making refined nutritious substances, conveyance of the thick essence to Heart, transporting essential substances to the Liver, ascending the clear and descending the turbid, coordinating heart-kidney, regulating stomach and calming the nerves, and origin of insomnia in modern time, such as anxiety causing qi stagnation, over improper diet and ovel-tiredness, endogenous phlegm heat, constitution on causing disease; and yin yang disharmony of Qi and phlegm, heart-spleen deficiency, sputum crudum causing by spleen asthenia, Liver and Spleen.Third partThis part introduces main therapies for insomnia according to thoughts ofRegulating qi and resolving phlegm, including strengthening spleen and benefiting vital energy, benefiting Heal-t and Spleen, eliminating heat and dissipating phlegm, regulating Qi and stomach, soothing liver and regulating stomach, and supplying successful clinical cases, and then the cases of changing of method of harmonizing Qi and phlegm. I learn from ProfessorZhu Jiangui, and gather 558 cases in his clinical time. I import the clinical data into computer, adopting the method of man-machine integration and mainly by man, and start to statistical analysis, arranging Professor Zhu Jiangui’s experiences of treating insomnia. Thus cansummarize main Zhenghou, frequently used therapies, set recipes and traditional Chinese drugs.and then summarize Professor Zhu Jiangui main prescriptions Of treating insomnia.The clinical research of Decoction of harmonizing middle energizer to calm the nerves treating insomnia We arrange Professor Zhu Jiangui’s empirical formula of treating insomnia, Decoction of harmonizing middle energizer to calm the nerves, using random controlled clinical method, to observe the clinical therapeutic effects of Decoction of harmonizing middle energizer to calm the nerves treating insomnia caused by phlegm heat harassing Heart. Results:Decoction of hal-lnonizing middle energizer to calm the nerves, treat insomnia 39 cases, fully recovered 6 cases, excellent 10 cases, in effect 17 cases, useless 6 cases. Total effective rate is 84.62%. There is no significant difference between treatment group with Decoction of harmonizing middle energizer to calm the nerves, and control group with estazolam. The treatment group gets better curative effect. Decoction of harmonizing middle energizer to calm the nerves does better in releasing symptoms such as frightening dream in sleeping and appetite, and can raise the quality of patients’ sleep and life. Decoction of hanllolllzlllg middle energizer to calm the nerves treating insomnia is worth of ful-ther research. |
