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基于命门火衰论交通心肾治失眠OA

Discussion on Restoring Interaction Between Heart and Kidney in the Treatment of Insomnia Based on the Theory of Decline of Life Gate Fire

中文摘要英文摘要

中医学认为,心肾阴阳的协调运作是维系正常睡眠-觉醒节律的核心机制,其本质遵循"阳主阴从"的动态平衡规律.当命门相火虚衰时,阳气失于蒸腾气化之能,导致水液代谢障碍,水饮内停,痰浊壅滞,这些病理产物阻滞少阴经枢机通道,使心、肾之间的气机升降出入受阻,进而引发失眠;或阴阳俱损,虚火上浮,扰及心神,引发失眠.针对命门火衰型心肾不交失眠症的治疗,应以温补命门阳气、安定神明为根本法则,同时配合祛除水饮、化解痰火、引火归元等治法,通过恢复心肾阴阳的升降交泰,最终实现睡眠节律的正常化.

Traditional Chinese medicine(TCM)posits that the coordinated interaction between the yin and yang of the heart and kidney is the fundamental mechanism underlying normal sleep-wake rhythm regulation,operating under the dynamic equilibrium principle of"yang as the master,yin as the follower."When the ministerial fire of the life gate declines and becomes deficient,it impairs yang qi's steaming and transforming functions,leading to water metabolism disorders,internal retention of water-fluid,and phlegm-turbidity stagnation.These pathological products obstruct the pivotal pathway of the Shaoyin meridian,impeding the ascent,descent,exit,and entry of qi movement between the heart and kidney,consequently triggering insomnia.Alternatively,when both yin and yang are damaged,deficiency fire flares up and disturbs the heart spirit,thereby also causing insomnia.For treating insomnia due to heart-kidney interaction disorder of the ministerial fire decline of life gate type,the fundamental therapeutic principle should be warming and supplementing the yang qi of the life gate to tranquilize the spirit.This should be combined with adjunctive therapies such as dispelling water-fluid,resolving phlegm-fire,and conducting fire back to its source.By restoring the ascending-descending and harmonious interaction of heart-kidney yin and yang,the normalization of the sleep rhythm can ultimately be achieved.

叶文彬;韦启志;蔡晓靖;庄隆志;庄日耀;洪怡芯

厦门市中医院全科医学科,福建 厦门 361000厦门市中医院全科医学科,福建 厦门 361000福建中医药大学,福建 福州 350108福建中医药大学,福建 福州 350108福建中医药大学,福建 福州 350108福建中医药大学,福建 福州 350108

医药卫生

失眠症命门火衰心肾不交病理产物阳升阴降温阳安神

InsomniaDecline of life gate fireHeart-kidney interaction disorderPathological productsYang ascending and yin descendingWarming yang to tranquilize the spirit

《新中医》 2026 (8)

166-169,4

2022福建省厦门市医疗卫生指导性项目(3502Z20224ZD1174)

10.13457/j.cnki.jncm.2026.08.027

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