陈士铎从脏腑五行生克辨治不寐经验探析OA

Based on Chen Shiduo's four works—Waijing Weiyan(Subtle Words on the External Classic),Bianzheng Lu(Records of Pattern Differentiation),Shishi Milu(Secret Records of the Stone Chamber),and Bencao Xinbian(New Compilation of Materia Medica)—this article explores his clinical experience and medication characteristics in diagnosing and treating insomnia under the guidance of the Five-Element Engendering-Restraining theory of the Zang-Fu Organs.Chen believed that the etiology and pathogenesis of insomnia lie in the failure of interaction between the heart and kidney,as well as the impaired mediation of the liver and gallbladder.Specifically,the harmonious interaction between heart fire and kidney water constitutes a prerequisite for sleep,while the mediation of the liver and gallbladder between the heart and kidney serves as a necessary guarantee.The zang-fu organs influence one another through the generative and restrictive relationships of the Five Elements.In terms of medication,Chen did not limit his approach to a single organ.Instead,he skillfully applied the Five Elements theory,employing treatments such as tonifying the lung to benefit the kidney,nourishing the kidney to support the liver,reinforcing the liver to nourish the heart,and supplementing the heart to strengthen the gallbladder,thereby addressing deficiencies in the heart,kidney,liver,and gallbladder.He also used method like"using water to rescue fire"to clear floating heat from these four organs.Additionally,he adeptly utilized specific medications such as Suanzaoren(Semen Ziziphi Spinosae)and Baijiezi(Semen Sinapis),reflecting a holistic concept of Five Elements regulation among the viscera and a flexible approach to medication.