However, Chinese medicine believes that in modern life, insomnia is mostly caused by overeating, stress and irregular work and rest, which leads to poor transport of spleen and stomach, endogenous pathogenic heat, phlegm-heat accumulation, phlegm-heat interaction, qi ascending, blocking the mind, causing anxiety or phlegm-heat, blocking qi-flow, qi-flow disorder, and yang-qi not entering Yin, thus leading to insomnia. Therefore, insomnia caused by phlegm-heat disorder is one of the most common types.
Among many TCM syndromes of insomnia, phlegm-heat syndrome is the most common one in clinic. In The Complete Works of Ancient and Modern Medicine by Xu Chunfu, a Ming Dynasty physician, there is such a description: "Too many people suffer from insomnia because of phlegm-fire disturbance, anxiety, excessive thinking and excessive phlegm." Chinese medicine believes that all diseases are caused by phlegm. Phlegm and turbidity disturb the mind, forming a state in which the clear gas does not rise and the turbid gas does not fall, making people feel confused and heavy, sweating uncomfortable, and the mouth is sticky and thirsty. Phlegm can lead to imbalance of yin and yang, imbalance of viscera and qi, and even affect people's mental state.
Phlegm is caused by a variety of internal and external factors acting on human body, damaging the function of viscera, causing water and liquid metabolism disorder and body fluid stagnation. After phlegm is formed, it has different pathological properties due to different constitutions. If it is a constitution with yin deficiency and internal heat, or because of exogenous pathogenic heat, spicy diet and other factors, phlegm and blood stasis are easy to turn into phlegm heat. "Sleepless Jingyue Encyclopedia" quoted Xu as saying: "Too many people are restless because of phlegm, too worried, and the fire is blazing with phlegm, which leads to insomnia."
Phlegm heat, as a pathogenic factor, destroys the balance and coordination of yin and yang, makes yang floating outside, "not entering yin", disturbs the mind and makes it insomnia. It can be seen that insomnia caused by phlegm-heat must have two factors: pathological factors of phlegm-heat and uneasiness.
The clinical manifestations of insomnia with phlegm-heat syndrome recorded in the Guiding Principles for Clinical Research of New Chinese Medicine by the Ministry of Health are restless sleep, upset, chest tightness, fullness, excessive phlegm, dizziness, bitter taste, yellow and greasy tongue coating and slippery pulse, among which restless sleep is the main symptom of insomnia and has no dialectical value for all insomnia patients. Disturbance is a unique symptom of phlegm-heat insomnia and irritability. Because the heart is the organ of Yang, which is in charge of fire in the five elements, the evil of phlegm-heat is most likely to disturb the mind and cause anxiety in the heart. Chest tightness, fullness, excessive phlegm, dizziness, bitter taste, yellow greasy fur and slippery pulse are typical manifestations of phlegm-heat syndrome, so it is not difficult to distinguish phlegm-heat insomnia.
However, many insomnia patients do not have the typical information of the above four diagnoses. In this regard, experts said that it is necessary to proceed from clinical practice, through the excavation, analysis, summary and reasoning of clinical phenomena such as pathogenic characteristics of phlegm-heat pathological factors, and judge the pathological essence of phlegm-heat according to the requirements of seeking "machine".
1, discrimination from gastrointestinal symptoms
Phlegm-heat insomnia is often accompanied by gastrointestinal dysfunction symptoms, mainly manifested as chest tightness, abdominal distension, common belching, nausea, constipation, dry or sticky stool, smelly stool, uncomfortable defecation or abdominal distension. Phlegm is everywhere, phlegm heat stops in the intestine, and the intestine is blocked by qi. Because of the difference of phlegm heat, it shows completely different characteristics.
2. Differentiate from physical symptoms.
Obesity, greasy head and face, reddish complexion, seborrheic alopecia and other insomnia patients. It is an important dialectical basis for insomnia with phlegm-heat syndrome.
Phlegm and turbidity are endogenous, which hinders spleen transport and transformation, and Shui Gu's subtle energy can not be transmitted normally, and phlegm and dampness accumulate under the skin, which is easy to be obese; Phlegm is yin, phlegm is sticky, and heat is yang evil. On the other hand, it is inflammatory in nature and burns rapidly, forcing visible phlegm to the body surface. If it is airtight, it will make the head greasy and the face red. The clinical manifestations of seborrheic alopecia are greasy hair, itchy dandruff, and sparse hair on the forehead and forehead, which leads to alopecia. "Hair outside the blood", because phlegm heat is smoked on the body, the veins are blocked, the blood and blood are not smooth, the essence and blood are not biochemical, and the hair roots are nourished, leading to tiredness and shedding.
3 Distinguish from limb symptoms
Insomnia patients are accompanied by dizziness, even if they are wrapped tightly, the limbs are tired and weak, the rainy days are aggravated, and the face or limbs are swollen, which can also be used as the dialectical basis for phlegm-heat insomnia.
"Danxi Heart Method": "Phlegm is a thing, rising and falling with qi, everywhere". Phlegm and dampness stagnate meridians, muscles, bones and muscles, and qi and blood are not running smoothly. If the joints of limbs are not nourished, they will be heavy and weak. Spleen governs the transport and transformation of body fluids, and "likes dryness and hates dampness". Excessive phlegm-dampness is easy to damage spleen yang, spleen loses transport, water and gas are unfavorable, body fluid stops gathering, and overflow leads to facial paralysis and limb swelling. On Su Wen's Drinking Yang Yingxiang: "Clearing Yang comes from the upper orifices", "Clearing Yang produces phlegm" and "clearing Yang strengthens limbs". The superficial limbs of head muscles depend on the warm nourishment of Qing Yang Qi. Phlegm is yin and evil, and phlegm is damp. If Qing Yang does not rise, the head is heavy and tight, and the limbs are tired and lazy.
At present, the pace of social life is accelerating, and the pressure of work and family is great. People are often depressed, nervous, anxious, and depressed liver, which will turn into fire after a long time; In addition, young and middle-aged patients are often full of yang, and phlegm-dampness and emotional disorder will often lead to stagnation of fire if they damage the body and qi stagnation and dampness block phlegm and turbidity; If it is caused by phlegm-dampness, spleen and stomach are out of harmony, water and liquid are out of harmony, and phlegm-dampness is even worse. The heat for a long time will disturb the mind and cause insomnia; If it is emotional disorder, qi stagnation will turn into fire for a long time, and body fluid can be decocted into phlegm, which will disturb the spirit and cause insomnia.
Therefore, phlegm-heat is the key factor of insomnia in young and middle-aged patients, so the treatment is mainly to clear away heat and phlegm, clear the heart and soothe the nerves.
Huanglian Wendan Decoction is commonly used in clinic to treat insomnia caused by phlegm-heat disturbance. Huanglian Wendan Decoction was first seen in Six Causes of Syndrome Differentiation. In the prescription, Coptidis Rhizoma and Zhuru clear away heart fire and resolve phlegm, Fructus Aurantii Immaturus, Pinellia ternata and Tang Hong promote qi circulation and resolve phlegm, Poria strengthens the spleen and eliminates dampness, and ginger and licorice warm the middle warmer and strengthen the spleen, thus avoiding injury caused by excessive cooling and dryness. Adding Rhizoma Anemarrhenae, Radix Bupleuri and Radix Paeoniae Alba to Huanglian Wendan Decoction can strengthen the functions of soothing the liver, relieving depression, nourishing yin and clearing heat, adding Semen Ziziphi Spinosae can soothe the nerves, and adding Atractylodes macrocephala can help Poria and strengthen the spleen. On the basis of clearing away heat and resolving phlegm, clearing away heart fire and calming the nerves, this prescription is supplemented by soothing the liver to relieve depression, regulating the liver and promoting blood circulation, so that soothing the liver can help calm the nerves.
Phlegm-heat insomnia is not only manifested by the above typical symptoms, such as chest tightness, abdominal distension, excessive phlegm, bitter taste, yellow and greasy tongue coating, and slippery pulse. On the basis of comprehensively and emphatically collecting the data of four diagnostic methods, the phlegm-heat syndrome is analyzed and reasoned by using the theory of traditional Chinese medicine, so as to eliminate the rough and extract the essence, and eliminate the false and retain the true. Only by comprehensive judgment from exterior to interior can we get the diagnosis of phlegm-heat insomnia. Therefore, when insomnia symptoms appear, it is recommended to consult a professional doctor and treat under the guidance of a doctor. Don't take medicine without authorization.
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