别明珂　蔡虎志　陈青扬　邓旭　李兰心　彭艳斌　陈新宇

〔摘要〕 膏方属于中医八大剂型之一，在慢性疾病调治方面有独特优势。慢性失眠病程较长，病情演变复杂，难以根除，运用膏方分时施治，可全面兼顾。陈新宇教授认为失眠的发生与阳气状态异常关系密切，阳虚、阳郁、阳亢等状态均可引起气血津液的代谢失常，导致阴阳逆乱，诱发失眠。治疗上，陈教授擅长调整人体寤寐节律，使之顺应自然界阴阳消长之道。于温阳之外，潜阳、固阳、通阳、升阳、泻火诸法随症参用;且不拘于治阳，以阳为主，以阴血为从，兼顾痰瘀湿热之累积;在解决患者睡眠障碍的同时，全方位、多角度进行整体调节，能够显著提高患者生活质量。

〔关键词〕 慢性失眠;四时调阳;阳主阴从;膏方;陈新宇

〔中图分类号〕R2-0       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.01.020

〔Abstract〕 Cream formula， one of the eight traditional Chinese medicine dosage forms， has unique advantages in the treatment of chronic diseases. Lasting for a long period， chronic insomnia is difficult to cure because of its complex evolution. By applying the medicine in the cream formula based on time change， chronic insomnia can be treated in a more comprehensive way. Professor Chen Xinyu holds that the occurrence of insomnia is closely related to the abnormal state of Yang qi. Yang deficiency， Yang depression， Yang hyperactivity and other abnormal states can cause metabolic disorders of qi， blood and body fluid， leading to the disorder of Yin and Yang， which causes insomnia. Professor Chen is expert in regulating the human sleep rhythm to conform to the natural law of Yin and Yang. In addition to warming Yang， the treatment methods of lowering Yang， fixing Yang， activating Yang， rising Yang and purging fire are used according to the change of symptoms; not only Yang is adjusted， but also Yin blood is taken as the follower while Yang goes ahead， and the accumulation of phlegm， blood stasis and damp heat is taken into account as well; with the problem of insomnia solved， patients' life quality can be significantly improved through adjustments of comprehensive aspects and multi-dimension.

〔Keywords〕 chronic insomnia; four seasons regulating Yang; Yang dominates and Yin follows; cream formula; CHEN Xinyu

失眠是指盡管有合适的睡眠机会和睡眠环境，依然对睡眠时间和（或）质量感到不满足，并且影响日间社会功能的一种主观体验[1]。流行病学研究表明，中国有45.4%被调查者在过去的1月中经历过不同程度的失眠[2]。病程超过3个月而难以缓解者称为慢性失眠，可导致多种躯体及精神疾病发病率上升[3]。陈新宇教授是湖南省名中医、博士生导师、首批全国优秀临床人才，潜心临证数十载，积累了丰富的临床经验。陈教授认为， 维持人体寤寐节律有赖阳气的正常运行，阳气状态与自然界四时变化相通应， 从而提出在“四时调阳”理论指导下进行分时施治，并擅长运用膏方调整阴阳气血的动态平衡。……