In the previous popular science articles, I also told you that the key to the pathogenesis of insomnia lies in the imbalance of yin and yang. If the yin and yang of the human body are out of balance, it will be uneasy and cause restless sleep.
Su Wen's "On Angry Days" clearly points out that "a good yang nourishes the mind and a soft one nourishes the tendons", and those who are full of yang will feel refreshed and calm, just as we will feel comfortable after proper exercise. In fact, this is mainly the result that exercise can generate yang and be supplemented.
But in modern society, people often face the pressure of work, life and study, and the irregularity of staying up late and working and rest will inevitably lead to the damage of Yang. It may also be that the acquired diet is unrestrained, the diet tends to be cold and overworked, or it may be that it has not healed for a long time, careless medication, sedentary and easy to lie down, and it is in an air-conditioned environment for a long time. These factors will lead to the gradual consumption of yang.
When the yang is gradually declining, the yin is cold, forcing the yang to surpass, and the yang cannot enter the yin, leading to insomnia. This is insomnia due to deficiency and cold, and it is also a common cause of insomnia for many modern people. Moreover, this type of insomnia is more common in patients who have been cured for a long time and have no obvious signs of yang heat.
Deficiency-cold insomnia is a very common type of insomnia, and its pathogenesis is closely related to the excessive consumption of yang in patients. Treatise on Febrile Diseases says: "For those who suffer from repeated sweating, irritability and insomnia during the day, quiet at night, no vomiting and thirst, no exterior syndrome, and weak and lukewarm pulse, Ganjiang Fuzi Decoction is the main prescription." It is pointed out that the irritability and insomnia caused by careless medication is caused by improper yang treatment.
There is also a record in "Medical Mind: Don't Lie": "Those who are disturbed by cold are warm and hidden, and God is also." It not only points out that excessive cold in the body causes anxiety and insomnia, but also discusses that "warming the body" is a treatment method to make the mind safe and insomnia heal itself. As the later doctors said, "Yang deficiency leads to guilty conscience, yin cold leads to prosperity, which disturbs the mind and makes it difficult to sleep." Yin and yang are both deficient and cold, which is like putting people in an freezer. Because of the cold, they will naturally be unable to sleep or find it difficult to enter a deep sleep state.
Therefore, this kind of insomnia patients often show symptoms such as shallow MUBI sleep, weakness of limbs, dizziness and excessive sweating, or palpitation, aversion to heat and cold, dark tongue and so on.
For the treatment of insomnia of deficiency-cold type, we mainly start with the causes of patients' yin deficiency and yang hyperactivity, and take the treatment of warming yang as the core in the treatment process, combined with other reasons to cause insomnia. There is a saying in "Jing Yue Quan Shu Insomnia": "Those who have evil but don't sleep, get rid of their evil and be at peace with themselves. Therefore, the treatment of wind-cold must eliminate pathogenic factors, such as Chaihu Yin, Mahuang Guizhi and Wei Zi. He also advocated using warm herbs such as Herba Ephedrae, Ramulus Cinnamomi and Wei Zi to treat insomnia caused by pathogenic wind-cold disturbance.
In actual treatment, the commonly used clinical prescriptions are Ganjiang Fuzi Decoction, Guizhi Gancao Decoction, Guizhi Gancao Gulong Muli Decoction and so on. Treatise on Febrile Diseases also records that "Guizhi Gancao Decoction is the first choice for those who suffer from insomnia and palpitation caused by excessive sweating and insufficient heart yang". This prescription uses cassia twig to warm and nourish yang, and licorice to warm and replenish qi. The combination of the two drugs can calm the heart yang, warm the meridians and dredge Yang Can, so that the yang qi is warm and the yin and yang merge, so it can treat insomnia due to yang deficiency or cold.
It should be noted that deficiency-cold insomnia is not only common in young people or middle-aged people who often stay up late or use drugs carelessly, but also in the elderly. Because the elderly are often accompanied by a variety of chronic diseases, long-term illness will consume blood and yang will gradually decline. Many patients will show the characteristics of Shaoyin disease, "Shaoyin disease, thin pulse, but drowsiness", which often shows upside down day and night, sleepiness during the day, insomnia at night, and deficiency of both yin and yang. In the treatment of warming meridians and activating yang, we should also choose prescriptions according to the physical condition of the elderly to avoid overdose, which will lead to greater damage to yang. Just as Chinese medicine pays attention to adapting to local conditions and adapting to the times, it must be one person at a time. Some insomnia patients are too tired for a long time, so they need to be helped step by step, and they need long-term conditioning to restore the balance between Yin and Yang and improve their sleep.
For example, Ms. Xu, a 66-year-old insomnia patient, suffered from insomnia repeatedly 10 years, and recently 1 year worsened. She found it difficult to fall asleep when she saw the doctor, even 1 stayed up all night on Monday. Sleeping pills are ineffective, nightmares are frequent, and she is upset at night. Eating sweets can relieve her slightly. Usually afraid of cold, cold hands and feet; Dizziness and fatigue, stomachache after cold, insomnia, headache and vomiting, with pale tongue and thin white coating on the tongue. Therefore, the syndrome differentiation is that the heart yang is insufficient, and the heart cannot be nourished, and the deficiency yang floats over and the deficiency wind is upset. The main treatments are warming meridians and activating yang, calming the heart and calming the nerves, calming the liver and calming the wind. The prescription is modified by Guigan Long Mu Decoction: roasted cassia twig, roasted licorice root, raw keel, roasted oyster, poria cocos and gastrodia elata; 15 dose. At the second visit, according to the description, after taking the medicine, I can sleep, stop the nightmare, sleep for 5-6 hours every night, have no headache, and get better mentally; And dizziness, cold hands and feet, frequent urination at night. Therefore, the dosage of lily, cinnamon, 15 was added to the top. At the third visit, sleep was further improved, sometimes sleeping for 7-8 hours, dizziness, cold hands and feet, and frequent urination at night were improved. Take more than 0/5 dose of/kloc-for consolidation therapy. After half a year's follow-up, sleep was normal and insomnia did not recur.
In this case, Ms. Xu suffered from insomnia 10 years, with many symptoms, and the sleeping pills were ineffective. This is a difficult problem of insomnia. A careful analysis of the characteristics of her insomnia shows that, in addition to sleepless nights, nightmares, night upset and other manifestations, she is also accompanied by cold symptoms such as chills, cold hands and feet, dizziness and fatigue, stomach pain after cold, pale tongue and thin white fur. Eating sweets can be slightly relieved, but it also suggests that it should be tonic.
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