基于“上下交损，当治其中”论治失眠

On the Treatment of Insomnia Based on “When Upper and Lower Intersection Lesions, the Middle Energizer (Spleen and Stomach) Should be Treated”

摘要: 叶天士在其著作《临证指南医案》中明确提出了“上下交损，当治其中”的理论，强调了中焦脾胃为气血化生之源，气机及阴阳升降之枢机，体现了中医学的整体观念和重视脾胃的学术思想。文章从中焦脾胃的角度出发梳理失眠的发病机制，治疗上采用畅气机、补脾胃养气血之法。“上下交损，当治其中”为失眠“治中”提供理论基础，为临床诊治提供进一步的明晰和借鉴作用。

Abstract: In his work “Clinical Guide to Medical Cases,” Ye Tianshi explicitly proposed the theory that “when upper and lower intersection lesions, the middle energizer (spleen and stomach) should be treated,” emphasizing that the middle energizer, the spleen and stomach, is the source of the generation of qi and blood, as well as the pivot for the movement of qi and the balance of yin and yang. This reflects the holistic concept of Traditional Chinese Medicine (TCM) and the academic thought that places great importance on the spleen and stomach. This article reviews the pathogenesis of insomnia from the perspective of the middle energizer spleen and stomach, in terms of treatment, it adopts methods to unblock qi movement, nourish the spleen and stomach, and enrich qi and blood. The principle of “when upper and lower intersection lesions, the middle energizer (spleen and stomach) should be treated” provides a theoretical foundation for the “treatment of the middle” for insomnia, offering further clarity and reference for clinical diagnosis and treatment.