[目的]探讨江苏省名中医顾锡镇教授治疗原发性失眠的临床经验.[方法]通过跟诊学习,收集相关病案,分析顾锡镇教授对原发性失眠中医病因病机的认识,总结原发性失眠的辨治经验,并附医案佐证.[结果]顾锡镇教授认为营卫运行是形成睡眠的最为重要的生理机制,阳不入阴是其病理理论基础,气血亏虚、脏腑功能失调是其致病因素.基于急则治其标、缓则治其本的原则,提出治疗当以重镇降逆、引阳入阴为先,结合补益气血阴阳、清热、化湿、理气、活血等方法,并于特定时间服药,临床疗效颇佳.[结论]顾锡镇教授运用重镇潜阳结合辨证论治治疗原发性失眠,疗效颇显,值得临床进一步学习与推广.%[Objective]To discuss the clinical experience of treating primary insomnia with Professor GU Xizhen, the famous Chinese doctor in Jiangsu Province. [Methods]To study the understanding of the etiology and pathogenesis of primary insomnia by Professor GU Xizhen, summarize the experience of treating primary insomnia based on the use of the key suppressing Yang and basing on the syndrome differentiation.[Results]Professor GU Xizhen thinks that the movement of the Ying and Wei is the most important physiological mechanism for the formation of sleep, and that Yang does not enter the Yin is the basis of the pathologic theory, the deficiency of Qi and blood and the dysfunction of the viscera are the pathogenic factors. Based on the urgent cure of the symptoms, delayed treatment of the fundamental principles, put forward the treatment when suppressing Yang into Yin first, on the basis of the emphasis on tonifying Qi and blood, Yin and Yang, clearing heat, removing the wet, regulating Qi activity etc, matching specific time of the drug. It can relieve both primary and secondary symptoms and get good results.[Conclusion]The treatment of primary insomnia by the Professor GU Xizhen is very effective. It deserves further study and promotion in clinical practice. One medical case is attached to prove the above conclusion.
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