Discussion on the Four-Season Pathogenesis and Treatment of Insomnia Based on the “Circular Movement of Yang Qi Ascending and Descending” / 中医杂志

ABSTRACT

In the perspective of the theory of “circular movement of yang qi ascending and descending”， the author explores the four-season pathogenesis and treatment of insomnia based on the seasonal changes of the body's yin-yang balance. It is believed that the core pathogenesis of insomnia lies in the spleen and stomach deficiency and the internal buildup of dampness. The four-season pathogenesis of insomnia focuses can be categorized into four aspects： abnormal ascending of yang qi in the spring， leading to the liver fire inflammation or the liver qi stagnation； Predominance of yang qi in the upper side of the heart and gallbladder fire in the summer； Lung disorder and abnormal descent of yang qi， resulting in yang-heat conversion into dryness or disharmony between nutrient qi and defensive qi； Abnormal hiding of yang qi， manifesting as floating yang or deficiency in both yin and yang in the winter. It is advocated to dynamically grasp the pathogenesis of insomnia in accordance with the changes in time. A treatment framework called “restoring ascending and descending of yang qi” is proposed， with the core focus on resolving dampness and strengthening the spleen， while also addressing the liver and strengthen the spleen， clearing and descending the heart and gallbladder， purifing and descending the lung qi， and suppressing hyperactive the yang and invigorating the kidneys in different seasons. This enrichment of the traditional Chinese medicine time medicine research in insomnia treatment， based on the characteristics of seasonal rhythmic time， aims to better serve clinical practice and provide ideas for the clinical diagnosis and treatment of insomnia.