从“五郁”理论探讨肿瘤相关性失眠的病机与治疗

Exploring the pathogenesis and treatment of cancer-related insomnia from the theory of “five depressions”

关键词:  肿瘤相关性失眠  中医疗法  五郁

Key words:  cancer-related insomnia  traditional Chinese medicine therapy  five depressions

摘要:

肿瘤相关性失眠是肿瘤患者极其常见的并发症之一，其患病率高，负面影响大。积极治疗可以提高患者对其他症状的耐受性与生活质量。肿瘤患者五行之气运动周流受到抑制，郁而不发，“五郁”内扰心神，引发失眠。文章从五郁论治失眠，苦寒清泄，以治金郁；清心发散，以治火郁；调补消导，以治土郁；疏通畅达，以治木郁；温宣利湿，以治水郁。文章将《黄帝内经》“五郁”理论联合肿瘤相关性失眠患者的临床表现，对肿瘤相关性失眠的辨治进行论述，期望对临床诊疗有所裨益。

Abstract:

Cancer-related insomnia is one of the most common complications in cancer patients，with high prevalence and significant negative impact. Active treatment can improve patients’ tolerance to other symptoms and their quality of life. In cancer patients，the normal circulation of the five elements’ qi movement is inhibited，leading to stagnation without release. The “five depressions” internally disturb the heart spirit，causing insomnia. The article discusses the treatment of insomnia from the perspective of the five depressions：using bitter-cold herbs to clear and purge，treating metal depression；clearing heart fire and dispersing heat，treating fire depression；regulating，tonifying，and resolving food stagnation，treating earth depression；soothing and unblocking，treating wood depression；warming，promoting diuresis，and resolving dampness，treating water depression. By integrating the theory of “five depressions” from the Huangdi Neijing（Yellow Emperor’s Inner Canon） with the clinical manifestations of patients with cancer-related insomnia，the paper discusses the pattern differentiation and treatment of cancer-related insomnia，hoping to provide benefit for clinical diagnosis and treatment.