基于七情理论探讨针灸治疗卒中后失眠的作用机制与调治

Exploring the Mechanisms and Therapeutic Regulation of Acupuncture for Post-Stroke Insomnia Based on the Seven Emotions Theory

摘要: 卒中后失眠是脑卒中后高发的神经精神并发症，其发生不仅与脑组织结构性损伤有关，更深受情志因素的显著影响。中医学认为“七情内伤”是失眠与中风共同的致病核心，现代医学则证实卒中后焦虑、抑郁等情绪障碍与失眠形成双向恶性循环。本文从中医学“形神一体”观与现代“脑–情绪–睡眠”轴理论出发，系统探讨情志因素在卒中后失眠发病中的关键角色，分析怒、思、悲、恐等情志过极对气机、脏腑及睡眠结构的具体影响，进而提出“调神安眠”调治策略，强调针灸在情志与睡眠双重调节中的价值，以期为卒中后失眠的临床诊疗提供新思路。

Abstract: Post-stroke insomnia (PSI) is a highly prevalent neuropsychiatric complication following stroke. Its pathogenesis is not only associated with structural cerebral damage but also profoundly influenced by emotional factors. Traditional Chinese Medicine (TCM) regards “seven emotions internal injury” as a shared pathogenic core underlying both stroke and insomnia, while modern medicine confirms that post-stroke emotional disturbances such as anxiety and depression form a bidirectional vicious cycle with insomnia. Drawing upon the TCM concept of “holism of body and spirit” and the modern “brain-emotion-sleep” axis theory, this review systematically explores the critical role of emotional factors in the pathogenesis of PSI, analyzes the specific impacts of excessive emotions—particularly anger, rumination, grief, and fear—on qi dynamics, visceral function, and sleep architecture, and subsequently proposes a therapeutic strategy of “regulating the spirit to tranquilize sleep.” Emphasis is placed on the value of acupuncture in the dual regulation of emotional states and sleep quality, aiming to provide novel insights for the clinical management of PSI.