TCM Internal Medicine · Classification of Insomnia by Syndrome Differentiation
Categorize common patterns of insomnia into "excess" and "deficiency" types, listing their treatment principles and representative formulas. Record the challenges in differentiating between Heart-Spleen Deficiency and Heart-Kidney Non-Intercommunication.
The pathogenesis of insomnia generally involves excessive Yang, deficient Yin, and disrupted communication between Yin and Yang. Textbooks classify it into deficiency and excess patterns: excess patterns often include Liver Fire harassing the Heart and Phlegm-Heat disturbing the Heart; deficiency patterns commonly involve Spleen and Heart Qi deficiency, Heart-Kidney non-interaction, and Heart-Gallbladder Qi deficiency.
| Syndrome Type | Main Manifestations | Treatment approach | Representative Formula |
|---|---|---|---|
| Liver Fire Disturbing the Heart | Insomnia with excessive dreaming, irritability and anger, bitter taste in the mouth, and red eyes. | Soothe the liver, clear heat, calm the heart, and tranquilize the mind. | Modified Longdan Xiegan Decoction |
| Phlegm-heat disturbing the heart | Insomnia due to irritability, chest and epigastric fullness, yellow greasy tongue coating. | Clears phlegm-heat, harmonizes the middle, and calms the spirit. | Huanglian Wendan Decoction with modifications |
| Spleen and Heart Deficiency | Difficulty falling asleep, frequent dreaming with easy awakening, palpitations, and fatigue | Tonify the heart and spleen, nourish blood, and calm the spirit. | Modified Guipi Decoction |
| Heart-Kidney Disharmony | Restlessness and insomnia, dizziness, tinnitus, and soreness in the lower back and knees. | Nourish Yin and clear fire; harmonize the Heart and Kidney. | Liuwei Dihuang Wan combined with Jiaotai Wan |
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