基于“阳维失维、阴跷失敛”理论探讨糖尿病合并失眠的病机与辨治思路

Discussion on the Pathogenesis and Differentiation‑Treatment Strategy of Diabetes Mellitus Complicated with Insomnia Based on the Theory of “Disordered Yangwei Vessel and Unconstrained Yinqiao Vessel”

摘要: 糖尿病合并失眠是临床常见的糖尿病并发症。中医奇经理论指出，阳维脉维系诸阳、固护肌表，阴跷脉敛阴固津、主司寤寐，二脉调畅、气机相交是维持人体昼夜节律与脏腑机能的重要保障，若二脉功能失调，则阴阳失交、百病由生。本文以阳维、阴跷脉理论为依据，探析二脉功能失常与消渴合并失眠的内在联系。消渴病程绵长，久病耗伤阴津，累及肝肾精血，致使维跷二脉失于濡养，扰乱人体营卫循行、阻碍阴阳交会、致使神魂失于安藏，最终引发睡眠失常、病情迁延难愈。本病治则以固维敛跷为核心，配合滋补肝肾、调和营卫、潜阳安神之法，使阳维固摄有度，阴跷敛藏有司，周身阴阳交贯顺畅，气血津液调和如常，以期为糖尿病合并失眠的中医临床辨证施治提供参考思路。

Abstract: Diabetes combined with insomnia is a common clinical complication of diabetes. The theory of traditional Chinese medicine Qijing points out that the yang meridian maintains various yang, solidifies and protects the muscle surface, the yin meridian tightens yin and solidifies body fluids, and regulates sleep. The smooth regulation of the two meridians and the intersection of qi are important guarantees for maintaining the circadian rhythm and organ function of the human body. If the function of the two meridians is disrupted, yin and yang will lose their connection, and various diseases will arise. Based on the theory of Yang Wei and Yin Qiao meridians, this article explores the intrinsic relationship between dysfunction of the two meridians and the combination of thirst and insomnia. The course of quenching thirst is long, and prolonged illness damages Yin and Jin, affecting liver and kidney essence and blood, causing the loss of nourishment for the two meridians, disrupting the circulation of the human body, obstructing the intersection of yin and yang, and causing the loss of the spirit in the safe storage, ultimately leading to sleep disorders and prolonged illness that is difficult to cure. The treatment of this disease focuses on strengthening the body and astringing the qi, blood and body fluid, with the method of nourishing the liver and kidney, harmonizing the Ying and Wei, and subduing the Yang and calming the nerves, so that the Yang dimension can be firmly absorbed with a certain degree, the Yin qi astringent and the Qi qi astringent can be kept in place, and the Yin yang can be connected smoothly throughout the body, and the qi blood and body fluid can be harmonious as usual, so as to provide a reference for the clinical treatment of diabetes combined with insomnia based on syndrome differentiation in TCM.