基于阴阳开阖枢理论治失眠OA

Based on the"opening-closing-pivoting"theory from the Inner Canon of Huangdi and integrating the academic thought of GU Zhishan,this paper systematically explores the innovative approach of Professor JIANG Hong,a renowned TCM physician in Liaoning province,in treating insomnia from the perspective of the dynamic Qi transformation of the three Yin and three Yang.Professor JIANG posits that"opening-closing-pivoting"reveals the laws governing the ascending,descending,exiting,and entering of Yin-Yang Qi movement:Taiyang as the"opening"governs defense externally;Yangming as the"closing"governs internal consolidation;Shaoyang as the"pivot"regulates Qi movement.The three Yin channels correspond accordingly,collectively forming a"Yin-Yang circular motion"system.Professor JIANG considers the essence of insomnia to be"dysregulation of Yin-Yang opening-closing-pivoting,"with failure of Yangming to descend and stagnation of the Shaoyang pivot as the core pathogenesis.She proposes a"six-channel time-differentiation treatment"strategy:locating the affected channel by correlating the patient's symptomatic time periods[e.g.,difficulty falling asleep during the Hai period(9-11 PM)implicates Taiyin,easy awakening during the Yin period(3-5 AM)suggests regulating Shaoyang]with the corresponding"time of potential relief"for each of the six channels as described in the Treatise on Cold Damage.Therapeutically,treatment is tailored to the specific channel:Opening Taiyang employs Guizhi class formulas to unblock yang and resolve fluid retention;Regulating Shaoyang utilizes Chaihu agents to soothe and facilitate the pivot mechanism;Closing Yangming selects Chengqi Decoction(承气汤)to purge the Fu-organs and direct Qi downward;Transporting Taiyin administers Lizhong Decoction(理中汤)to fortify the spleen and resolve dampness;Consolidating Jueyin employs Wumei Pills(乌梅丸)to harmonize cold and heat;Governing Shaoyin applies Huanglian Ejiao Decoction(黄连阿胶汤)to communicate the heart and kidney.This embodies the treatment essence that"smooth pivoting ensures Yin-Yang harmony."This theory integrates traditional Yin-Yang doctrine with chronomedicine,aiming to restore the human body's circadian rhythm by regulating the Qi transformation of"opening-closing-pivoting",highlighting the practical value of the"correspondence between heaven and human"holistic view in modern clinical practice.The author had the privilege of apprenticing under Professor JIANG Hong in clinical practice and has compiled her thoughts on treating insomnia based on the Yin-Yang opening-closing-pivoting theory for the benefit of peers.