基于“心主神明” 理论探讨不寐的辨证治疗

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【中图分类号】R249.2/.7 【文献标志码】A 【文章编号】1007-8517（2026）04-0089-05

DOI：10.3969/j. issn.1007-8517. 2026. 04. zgmzmjyyzz202604017

Exploring the DiferentialDiagnosis and Treatment of Insomnia Based on the Theoryof“Heart Governing the Mind"

ZHAO Hengyuan1ZHANG Xiumei2*OU Yanglili1WANG Peiyu1 1.The First Clinical Medical Collegeof Henan Universityof Chinese Medicine，Zhengzhou 45Oooo，China 2．The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 45OoOo，China

Abstract：Insomniaisacommon clinical disorder thatseriouslyendangers humanphysicalandmental health.Currently，the Westernmedicinetreatmentforinsomniahasissessuchasdependence，tolerance，andwithdrawalreactions.TraditionalChinese medicine（TCM）treats insomniabasedontheprinciplesof“holisticconceptandsyndromediferentiationandtreatment”，whichhas theuniqueadvantageofaddressngboththesymptomsandtherotcause，andthetreatmentmethodsarediverse.TisarticlesummarizesProfessorZhangXiumei'sclinicalexperienceintreatinginsomnia.Theprofesorbelieves thatthe“heartspirit”dominatesthefive visceraadsixbowels，ndtefivevisceraandsixbowelsaecttheregulationofth“heartspirit”，thatis，peoplesmentalotions andthinkingactivitieswillalsobeaffctedTedysfunctionof“heartgoveringthemid”andtheimbalanceofthefunctionsofthe fivevisceraandsixbowelscanleadtotheocurrenceof insomnia.Basedonthis，theetiologyandpathogenesisof insomiaareanalyzed，ndtetreatmentofisomiawithtraditioalChinesemediieisexplord.Sixreatmentmeodsforisomniaareproposedto provide ideas for the clinical diagnosis and treatment of insomnia.

Keywords：Insomnia；Heart Governing the Mind；Traditional Chinese Medicine Treatment；Syndrome Diferentiation

中医病名不寐又称“失眠”，《黄帝内经》中又称之为“卧不安”“不得卧”，通常是指在排除外界环境的影响下，仍然无法获得正常睡眠的一类病证，常见的临床表现有入睡困难、多梦、噩梦、早醒易醒、醒后难睡等，出现整体睡眠质量下降，进而导致白天精神欠佳、疲劳乏力、兴趣减退，甚至出现情绪失常或认知障碍等[1]

根据《2025中国睡眠健康研究白皮书》统计，我国约有 65% 的人群正经历着失眠症的困扰[2]，且近十余年来，国民平均睡眠时长有所缩减，大约为7个小时，甚至更短，而且睡眠质量亦有明显下降[3]。（剩余8717字）