中医杂志2026，Vol.67Issue(3)：252-257,6.DOI:10.13288/j.11-2166/r.2026.03.005
基于五观辨治体系从"郁"探讨肿瘤相关性失眠诊疗策略
Diagnostic and Therapeutic Strategies for Cancer-Related Insomnia from the Perspective of"Constraint"Based on the Five Viewpoints of Diagnosis and Treatment System
摘要
Abstract
Based on the five viewpoints of diagnosis and treatment theory,this paper proposes that"constraint"constitutes the core pathomechanism throughout the entire course of cancer-related insomnia(CRI).A dynamic diag-nostic and therapeutic framework for CRI is constructed through five viewpoints,the temporal-spatial viewpoint,core viewpoint,symptom viewpoint,precision viewpoint,and preventive(pre-disease)viewpoint.The temporal-spatial viewpoint elucidates the correlations between the course of malignancy and insomnia.The core viewpoint delineates the evolution of pathomechanisms,characterized by emotional constraint before treatment,drug-and toxicity-induced constraint during treatment,and kidney deficiency with toxin-related constraint during recovery,and corresponds to therapeutic principles including soothing the liver to relieve constraint and calm the hun(魂),strengthening the spleen and tonifying the lung to stabilize the po(魄),and tonifying the kidney to resolve toxins and tranquilize the mind.The symptom viewpoint guides herbal combinations according to different insomnia symptom clusters.The pre-cision viewpoint targets regulation of the neuro-endocrine-immune network and constitutional status.The preventive viewpoint establishes a three-tier prevention strategy.By moving beyond a traditional single-symptom management model,this approach achieves holistic regulation from root pathomechanisms to clinical manifestations,forming a full-course management strategy of"identifying constraint mechanisms,alleviating constraint-related symptoms,and pre-venting constraint-prone states",and provides a traditional Chinese medicine-based framework for improving CRI diagnosis and treatment.关键词
肿瘤相关性失眠/郁证/五观辨治Key words
cancer-related insomnia/constraint/five viewpoints of diagnosis and treatment引用本文复制引用
王紫霖,葛媛莎,李杰..基于五观辨治体系从"郁"探讨肿瘤相关性失眠诊疗策略[J].中医杂志,2026,67(3):252-257,6.基金项目
国家中医药管理局岐黄学者支持项目(国中医药人教函[2025]182号) （国中医药人教函[2025]182号）
2025年度"高创计划·登峰青苗春蕾"项目(G202514019) （G202514019）
福建省第三批柔性引进医疗卫生高层次人才团队项目(闽卫人函[2023]1480号) （闽卫人函[2023]1480号）
中央高水平中医医院临床科研业务费项目(HLCMHPP2023085,HLCMHPP2023001,HLCMHPP2023097) （HLCMHPP2023085,HLCMHPP2023001,HLCMHPP2023097）
国家自然科学基金(82274608) （82274608）
