基于"阳化气,阴成形"理论探讨缺血性脑卒中后睡眠障碍病机与治疗OA

Sleep disorders are common clinical complications of ischemic stroke,characterized by high incidence and high recurrence rate.The core clinical manifestations are difficulty falling asleep and sleep maintenance insomnia.Some patients may also be accompanied by symptoms such as daytime sleepiness and listlessness.In recent years,with the increasing incidence of ischemic stroke year by year,the prevalence of secondary sleep disorders has also shown a significant upward trend.This not only seriously hinders the recovery process of patients'neurological functions,delays the rehabilitation of limb movement,language and other functions,but also harms the physical and mental health of patients,induces negative emotions such as anxiety and depression,reduces the quality of life,and increases the risk of restroke.It has become an important factor influencing the prognosis of stroke patients.Based on the theory of"Yang(阳)transforming Qi(气)and Yin(阴)constituting form"in Huangdi Neijing(《黄帝内经》),and combined with the clinical features and pathological evolution of sleep disorders after ischemic stroke,this article proposes that the core pathogenesis lies in the functional imbalance of"Yang transforming Qi and Yin constituting form",along with the disharmony of Ying(营)Qi and Wei(卫)Qi and blood,ultimately leading to restlessness of the heart-brain-body and spirit.Among them,the failure of clear Yang to acsend and the blockage of the orifices by phlegm and blood stasis due to the insufficient transformation of Yang into Qi and the excessive formation of Yin-derived pathological products serve as the basis for the onset of the disease.Excessive Yang transforming of Qi and insufficient Yin constituting form,lead to an excess of Qi and fire,deficiency of body fluids and blood weakness,which are the key factors contributing to the disease evolution and difficulty in curing.Based on the principles of"holistic concept"and"syndrome differentiation and treatment"in traditional Chinese medicine,it is believed that the fundamental treatment for preventing and treating sleep disorders after ischemic stroke should be to harmonize Yin and Yang and restore the balance between"Qi transformation"and"form constitution".It also proposes the methods of combining warming and unblocking to harmonize Qi transformation,eliminating phlegm and dampness,promoting blood circulation and detoxification,relieving depression and clearing heat,nourishing Yin and enriching blood.Through combined treatment,the balance of Yin and Yang can be restored,thereby ensuring smooth flow of Yang Qi,the dispelling gloom,the eliminating stasis and turbidity,and replenishing Yin fluids,this leads to peace of mind and brain,as well as tranquility of both body and spirit.