王朋 张西 郑媛媛

摘要 赵吉平教授针刺治疗不寐，从病机入手，首先“调神”，脑神、心神同调，调脑神选头部腧穴，轻症、病程短者选“头三神”，重症、病程久者选“头十二针”;实证、虚证分别施以不同的刺激量，实现虚补实泻。调心神选心经、心包经远端腧穴，虚证、热象不著者，选原穴、络穴，实证、热盛者，选荥穴、井穴。次重调阴阳，阴阳跷脉与任督脉并用。再以四诊合参定证候，从脏腑辨证角度辨证配穴。针刺时强调从针具、针刺方向、深度、针刺手法的灵活配合，达到相应的刺激量。

关键词 失眠;针刺;临床经验;调脑神;调心神;平衡阴阳;四诊合参;辨证配穴

Professor ZHAO Jiping′s Experiences in the Coordination of Brain and Heart

and Balance of Yin and Yang in Insomnia with Acupuncture

WANG Peng1，ZHANG Xi1，ZHENG Yuanyuan2

（1 Dongzhimen Hospital，Beijing University of Chinese Medicine，Beijing 100700 China;

2 Beijing Chuiyangliu Hospital，Beijing 100022，China）

Abstract The first step is regulating the mind，including of the mind of the brain and the heart.Acupoints locating in the head are selected for regulating the mind of the brain.“Tou three spirits acupoints” are selected for mild patients，while “Tou twelve acupoints” for severe patients.Different stimuli are given to the deficiency and sufficiency syndrome separately.Acupoints of heart meridian of hand-shaoyin and pericardium meridian of hand-jueyin in the forearm and hand are selected for regulating the mind of the heart.The Yuan-Source and Luo-Connecting acupoints are seclected for those who with deficiency syndrome or without heat.While Ying-Spring and Jing-Well acupoints are selected for those who with sufficiency syndrome and heat.Second，balancing Yin and Yang by acupoints of yin heel and yang heel vessel，and governor vessel and conception vessel.Then the 4 methods of diagnosis combined with syndrome differentiation are used for selecting acupoints.It is important that the needling apparatus，direction，depth and manipulation techniques to achieve appropriate stimulation.

Keywords Insomnia; Acupuncture; Clinical experiences; Regulate the mind of the brain; Regulate the mind of the heart; Balancing Yin and yang; Comprehensive analysis of data gained by four diagnostic methods; Selection of acupoints based on syndrome differentiation

中图分类号：R249.2/.7文献标识码：Bdoi：10.3969/j.issn.1673-7202.2021.02.023

赵吉平，女，北京中医药大学教授、主任医师、博士研究生导师，北京市教学名师，北京市优秀教师。首批“全国优秀中醫临床人才”，北京中医药传承“双百工程”指导老师，国家中医药管理局针灸重点专科负责人。擅长在中医理论指导下，运用传统针灸诊治疾病。临证强调对疾病属“形病”“气病”“神病”不同的准确辨别，治疗时各有侧重，尤重“调神”在疑难杂症中的运用。

失眠的主证分为3种类型，即入睡困难、维持睡眠困难（频繁觉醒或醒后难再入睡）、早醒（且醒后难再入睡）[1]，部分患者同时出现2种及以上的症状。失眠症状发作每周≥3次、持续≥3个月属慢性失眠[2]。由于失眠常与多种慢性疾病、精神疾病三者之间互为因果，因此其诊断不需严格区分原发与继发，失眠既可以作为独立疾病诊断，也可归入其他疾病的并发症[3]。……