牛凤云老师运用补脾法治疗顽固性失眠的临证体会

Clinical Experience of Teacher Niu Fengyun Using Spleen-Tonifying Method to Treat Refractory Insomnia

摘要: 本文旨在总结牛凤云老师运用中医补脾法治疗顽固性失眠的思路和经验。跟随牛老师诊病期间发现，多数顽固性失眠患者常表现为症状反复不愈，西医多采用镇静催眠药物治疗，但易出现疗效不佳、依赖及副作用较多等问题，属临床疑难杂病范畴。而中医辨证论治本病常能取得较好疗效。该病中医病名为“不寐”，老师秉持中医整体观念，强调强健脾土为治疗不寐之根本，针对各种原因导致的失眠，以补脾法为基础，随证加减，灵活化裁，效果较好。本文阐述了中医对顽固性失眠病因病机的认识，以及基于补脾法基础上用药原则及方法，为顽固性失眠的中医治疗提供师承学术思路与临床参考。

Abstract: This article aims to summarize Teacher Niu Fengyun’s approach and experience in using traditional Chinese medicine’s method of tonifying the spleen to treat refractory insomnia. During my observation of Teacher Niu’s diagnosis, it became apparent that most patients with refractory insomnia often exhibit recurring symptoms that do not improve. Western medicine typically employs sedative-hypnotic medications, but these can lead to issues such as suboptimal efficacy, dependence, and numerous side effects, which fall under the category of complex clinical conditions. In contrast, traditional Chinese medicine’s syndrome differentiation and treatment method often yield better results. The traditional Chinese medicine diagnosis for this condition is “Bu Mei (Insomnia)”. Teacher Niu adheres to the holistic principles of traditional Chinese medicine, emphasizing the fundamental role of strengthening the spleen in treating Bu Mei (Insomnia). He addresses various causes of insomnia by basing treatment on the method of tonifying the spleen, making adjustments according to the specific symptoms, and employing flexible strategies. This article elucidates traditional Chinese medicine’s understanding of the etiology and pathogenesis of refractory insomnia, as well as the principles and methods for using treatments based on tonifying the spleen. It provides a scholarly approach and clinical reference for the treatment of refractory insomnia using traditional Chinese medicine.