功能性便秘伴失眠的中医共病认识及五脏同调辨治思路研究进展

Research Progress on the Traditional Chinese Medicine Understanding of Comorbidity of Functional Constipation with Insomnia and Its Diagnosis and Treatment Based on Five-Zang Co-Regulation

摘要: 功能性便秘与失眠均为临床常见病证，二者可通过脑肠轴、自主神经功能、昼夜节律及肠道菌群等途径相互影响，形成共病状态。中医学认为，功能性便秘虽病位在大肠，但与心、肝、脾、肺、肾功能失调密切相关；失眠虽责之于心神不宁，亦与五脏失和、五神失藏有关。五脏同调法从整体观念出发，强调安神与通腑并治，可为功能性便秘伴失眠的辨治提供思路。本文从现代共病基础、中医病机认识、五脏分脏辨治、临床研究现状及现代机制等方面进行综述，以期为该共病状态的中医临床辨治和后续研究提供参考。

Abstract: Functional constipation and insomnia are common clinical conditions. They may interact through the brain-gut axis, autonomic nervous function, circadian rhythm, gut microbiota and other pathways, thereby forming a comorbid state. In traditional Chinese medicine, although functional constipation is mainly located in the large intestine, it is closely related to dysfunction of the heart, liver, spleen, lung and kidney; insomnia, although primarily attributed to disturbance of the heart spirit, is also associated with disharmony of the five-zang organs and failure of the five spirits to be stored. Based on the holistic concept, the Five-Zang Co-Regulation Therapy emphasizes simultaneous treatment by calming the spirit and regulating bowel function, which may provide ideas for syndrome differentiation and treatment of functional constipation with insomnia. This article reviews the modern basis of comorbidity, TCM pathogenesis, organ-specific differentiation and treatment, current clinical research and modern mechanisms, aiming to provide references for TCM clinical differentiation and treatment and subsequent research on this comorbid state.