Etiology and treatment of insomnia from Neijing

Insomnia is called insomnia in traditional Chinese medicine, and its basic pathogenesis is: yang does not enter yin, and the mind is uneasy. From the perspective of yin and yang, the sleep process can be summarized as the following three aspects:

Yang entering yin: sleep

Yang moving to yin: dream

Yang comes from yin: wake up

The carriers specially regulating the rise and fall of Yin and Yang are mainly Qi Ying and Wei Qi, especially Wei Qi.

① Wei qi exercise and sleep

Camp guard is an important material basis of human life activities, and its normal operation is the basic life rhythm that human body must maintain. The normal operation of Wei-qi arouses people's daily sleep awakening, which corresponds to the circadian rhythm of nature.

"Lingshu Kouwen": "Wei Qi walks in the sun during the day, walks in the yin at midnight, dominates the yin at midnight, and lies down at night." "The sun be the spirit, YanQiSheng, eyes; The yin is exhausted and the yang is full. " Modern medicine believes that melatonin secreted by pineal gland is closely related to the rhythm of human sleep awakening. Our ancestors also expounded the relationship between human sleep and day and night in a more metaphysical way, using an old saying to describe "lying at sunrise and resting at sunset", but to put it into practice, it is necessary to rely on Wei Qi to alternate yin and yang with the weather.

"Shu Wei Qi Xing" has a more specific discussion on this. Therefore, 50 weeks of the line is in the body, 25 weeks in the sun in the day, and 25 weeks in the yin in the night, and it goes around the five internal organs. Therefore, the exhaustion of yang is the purpose, and when the eyes are open, the qi goes up to the head ... As for the foot, it goes into the heart, out of the medial malleolus, and divides the yin into the eyes. This is the way that Wei Qi moves in Yin and Yang as a whole. Specifically, the night is the sleep period of people, that is, the stage of "Yin receiving qi", that is, "Yang exhausts in Yin, and Yin receives qi". Starting from yin, it often goes from foot to kidney, kidney to heart, heart to lung, lung to liver, liver to spleen, and spleen to kidney. Therefore, it is a house at night, and the popularity is in the dirty week and the extremely dirty eight, just like the twenty-five weeks of the yang line, combined with the eyes. One day and one night, Yin and Yang have four odd parts and two very dirty parts. It is the reason why old friends lie up early, and strange points emerge one after another. "These are the physiological states of Wei Qi movement.

As for the mechanism of insomnia, the chapter "Ling Xie Shu Ke" has a detailed description, and introduces the principles and methods of treating insomnia.

"Stephy is the disaster of its fierce qi ... often from the lack of Yin qi to the internal organs. Today, when qi is trapped in the five internal organs, it can only be kept outside, moving in the yang and not entering the yin. If you walk in the sun, the sun will be full and the sun will be full. You must not enter the yin and yin deficiency, so you will not be disappointed. " This passage tells us that after Wei Qi was born, it could not sneak in when it was running in the yin, because the pathogenic factors were in the five internal organs. As a bridge between Wei Qi and Yin Qi, there are also problems. Can't run in Yang, so Yang is too full, but not enough. The difference between them further aggravates the difficulty of entry and exit in Wei Qi. Yang Qi is the main eye, and Yin Qi is the main eye. Therefore, we can control the pathway of defending qi to a certain extent by adjusting Qiao Mai, such as acupuncture at Zhao Hai point of Yinqiao pulse.

At the same time, regulating the spleen and stomach also plays an important role in safeguarding qi movement. First of all, the spleen and stomach are closely related to the formation of Wei Rong. In Five Flavors of Lingshu, "the valley begins in the stomach, and the subtle begins in the second jiao of the stomach to irrigate the five internal organs, and the two lines of ying and Wei are distinguished", and Lingshu nutrition will "camp from the middle jiao and Wei from the upper jiao". ("Upper jiao originates in the upper mouth of the stomach" and "Middle jiao also fits in the stomach"), so the source of nutrition and health should also be found in the spleen and stomach.

Secondly, the spleen and large intestine are also closely related to the operation of Yingwei. According to the summary of the circulation of Wei-qi in Neijing, Teacher Wang Hongtu thinks: "Wei-qi circulates in the Yang meridian during the day, starting from the bladder meridian of Foot-yang every week, it must be injected into Foot-shaoyin (kidney) through the Yangqiao pulse nourished by Foot-shaoyin kidney. That is, yin is the foundation of yang. Wei Qi walks in the five zang-organs at night, every line and one week, passing through the Yinqiao pulse at the spleen and meeting the bladder meridian of the foot sun once, which needs the encouragement of yang. That is, "yang is used for yin". Problems in every link in the process of defending qi will affect sleep and cause abnormal sleep, but the key to changing from yang to yin and from yin to yang lies in (the last stop): disharmony between the large intestine meridian of hand Yangming and the spleen and stomach of Taiyin will lead to restlessness.

② Water-fire fluctuation and sleep

It is impossible for the human body to be in a state of sleep, mainly because Yang can't hide in Yin, and Yin and Yang are in a state of repulsion, so they can't hide sympathetically. There are many cases of yin-yang disharmony, which are nothing more than two kinds: one is that yin deficiency can't receive yang, and the other is that Yang Can can't enter yin. For example, in Su Wen, "The lungs are covered by Tibet, and the lungs are full of qi, so the lungs are too big to lie down."

But the most common cause in clinic is heart-kidney imbalance, that is, fire and water are incompatible. There are two divination images in the Book of Changes, one is "Ji Ji", the other is "misfortune" and the other is "misfortune", which makes fire and water flourish and Ji Ji sleep peacefully. For example, when a person is not born, standing upside down in the womb naturally shows a state of being helpful. After he was born, he walked in the world, bound by foreign objects, and his heart burned to the ground, so he couldn't dive. The fire burns alone on the top and the water dries below, showing the image of no help.

In this case, on the one hand, we should pay attention to changing psychological state and bad living habits, on the other hand, we should pay attention to collecting hidden floating fire through drug maintenance of kidney water.

Treatment of insomnia

Ling Xie Shuke believes that the treatment of insomnia lies in "supplementing its deficiency, purging its surplus, regulating its deficiency and excess, clearing its way and eliminating its evil." In treatment, "drink a dose of Pinellia decoction, yin and yang have passed, and you must lie down."

The original text of Pinellia Decoction is as follows:

"Its soup is eight liters away from running water for thousands of times, take five liters, cook it, cook it with reeds, cook it with one liter of glutinous rice, five pinellia ternata, cook it with Xu, make it a liter and a half, get rid of its dregs, drink its juice cups, and be more and more aware, so new patients drink a cup and sweat.

Every sentence here embodies the above law. First of all, its boiling water is "eight liters for those who run thousands of miles and five liters for those who run ten thousand times", and the fire is hollow "reed fire", and then it is fried for a long time to remove slag. These three points have a * * * nature-light and clear; Secondly, glutinous rice is used to soothe the nerves and nourish the stomach, which is the source of nutrition and health and is "insufficient". Pinellia ternata is used for resolving phlegm and drinking it in the stomach to "purge excess" and "remove evil". But there are so many medicines for resolving phlegm in the stomach, why choose Pinellia ternata? Its growth mode is very special, and it is born of Yin qi, which can well reflect the meaning of Yang entering Yin (similarly, Prunella vulgaris is also commonly used for insomnia, and it is born of Yang qi. For example, in Leng Lu Yi Tan, it is compatible with Pinellia ternata to balance yin and yang and cure insomnia that all prescriptions can't cure, and the effect is very good. Zhang Xichun believes that "Pinellia ternata was born in the summer half year, which is the exchange of Yin and Yang. In fact, it is the waiting from Yang to Yin, so it can communicate with Yin and Yang, so that the Yang in the heart gradually hides in Yin and goes to sleep."

In the aspect of acupuncture treatment, we can learn from the technique of "stabbing Wei does not hurt Wei and stabbing Wei does not hurt Rong" in the difficult classics, that is, when stabbing Wei, we should lie in the prone position, press the points first when stabbing Rong, and then close the needle after the qi disappears. The specific acupoint selection is mainly based on the obstruction of camp and health, and the reinforcing and reducing operation follows the principle of "supplementing its deficiency and reducing its surplus". For reinforcing and reducing operations, please refer to "Reinforcing the middle energizer to protect qi" in Difficult Classics. When you have loose bowels, you should be angry with the glory. Its yang is insufficient and its yin is surplus, so it is necessary to replenish its yang first and then drain its yin; Yin Qi is insufficient, and Yang Qi is surplus, so we should first tonify yin and then diarrhea yang. Roewe's access is crucial.