Research progress in the prevention and treatment of insomnia with classical prescriptions

Abstract

Insomnia is a common disease and its impact on human health cannot be ignored. At present, there are 3 main clinical treatments for insomnia, including traditional Chinese medicine treatment, sedative hypnotic drug therapy, and cognitive behavioral therapy. Traditional Chinese medicine (TCM) treatment for insomnia is widely used due to its advantages of low side effects, good efficacy, and no drug dependence. This paper summarizes the pathogenesis of insomnia in the theories of traditional Chinese and Western medicine. Modern medical research generally believes that sleep-wake disorder is the main pathological mechanism of insomnia, involving many factors such as monoamine neurotransmitter disorder, cytokine imbalance and intestinal flora imbalance. TCM mainly divides the pathogenesis of insomnia into 9 kinds of syndrome types: Liver depression transforming into fire, hyperactivity of fire due to yin deficiency, phlegm-heat attacking internally, disharmony between heart and kidney, deficiency of both heart and spleen, qi deficiency of both heart and gallbaldder, stomach qi disharmony, exuberance of heart fire, and internal blockade of static blood. According to these 9 kinds of pathogenesis of insomnia, the corresponding classical prescriptions such as Longdanxiegan decoction, Suanzaoren decoction, Huanglian-Wendan decoction, Jiaotai pill and Guipi decoction were analyzed and summarized. There is evidence that traditional Chinese medicine could treat insomnia mainly by increasing the level of 5-hydroxytryptamine, reducing the levels of dopamine, noradrenaline, tumor necrosis factor α, and interlukin-6, decreasing the ratio of glutamic acid to γ-aminobutyric acid, and inhibiting the hypothalamic-pituitary-adrenal axis.

Keywords: classical prescriptions; insomnia; mechanism.

图1

失眠的现代病理生理机制 Figure 1 Pathological mechanism of insomnia in modern medicine GABA: γ-Aminobutyric acid; ORX: Orexin; MT: Melatonin; CRH: Corticotropin releasing hormone; NE: Noradrenaline; COR: Cortisol; DA: Dopamine; 5-HT: 5-Hydroxytryptamine; Glu: Glutamic acid; ACTH: Adrenocor ticotropic hormore; →: Promote; : Inhibit; : Mutually inhibit. Pathways associated with arousal are represented by red lines, and pathways associated with sleep are represented by black lines.