北京中医药大学学报2025，Vol.48Issue(5)：652-657,6.DOI:10.3969/j.issn.1006-2157.2025.05.008
从贼火与子火探讨围绝经期失眠的辨治思路
Exploring differentiation and treatment strategies for perimenopausal insomnia through thief and child fire
摘要
Abstract
Perimenopausal women are more susceptible to fire pathogen disturbances,often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels,as well as the insufficiency of the essence and blood of the viscera.CHENG Zhongling's theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet,leading to syndromes such as food retention in the stomach or phlegm-fire stagnation.In contrast,child fire is generated endogenously,often owing to liver and kidney deficiency,resulting in an imbalance of water and fire and liver dysfunction,leading to excessive fire transformation.This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia.An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented,along with a detailed discussion of corresponding treatment strategies.For the invasion of thief fire,therapeutic approaches include ascending and dispersing stagnant fire,clearing and moistening to remove interior heat,purging the heat accumulation to unblock the bowels,and subduing the fire and nourishing yin to eliminate depression.When child fire disturbs the spirit,treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat,nourishing the true yin to restrain the yang,warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi,and guiding and reducing the deficient heat to remove the floating fire.Clinical practice necessitates precise identification of thief and child fire,thorough investigation of exogenous pathogens and internal damage,and careful differentiation between deficiency and excess,as well as the superficial and internal aspects.Strict adherence to the treatment principle of"nourishing the child fire can drive out the thief fire,but driving out the thief fire should not harm the child fire"ensures a balanced approach.By harmonizing the yin and yang of the viscera and allowing the mind to be at ease,this strategy effectively alleviates perimenopausal insomnia.The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.关键词
围绝经期/失眠/医学心悟/火邪Key words
perimenopausal period/insomnia/Medical Insights/fire pathogen分类
中医学引用本文复制引用
李曾妍,杨月月,胡炜圣,刘锋,王磊,李昭君,赵欣玥,符文彬..从贼火与子火探讨围绝经期失眠的辨治思路[J].北京中医药大学学报,2025,48(5):652-657,6.基金项目
国家自然科学基金联合基金项目(No.U23A20507) National Natural Science Foundation of China(No.U23A20507) （No.U23A20507）
