中西医结合慢性病杂志

基于《周易》“水火既济”与“未济-既济”卦象演变理论，可系统阐释眼针疗法治疗心肾不交型失眠的理论基础与诊疗特色。中医学认为，既济卦象征心肾相交的生理常态；未济卦则对应心肾失交的病理状态，其核心在于坎（肾）中真阳与离（心）中真阴的升降失常。心肾交泰的实现，有赖于中焦脾胃的枢轴运化及肝肺的协同调控。依据水火阴阳失衡的具体机制，将心肾不交型失眠系统划分为以下4类证候：（1）君相失调，火浮水寒；（2）心肾阳衰，神无所依；（3）水亏火旺，失制于上；（4）本元亏耗，虚阳浮越。眼针疗法以“坎离交泰”为核心，选取后天八卦分区中离卦对应的心小肠区及坎卦对应的肾膀胱区为主穴，通过激发坎中真阳、涵养离中真阴，促进“未济”向“既济”转化；并灵活配伍脾胃区、肝胆区、肺大肠区等，以健运枢轴、调畅气机、通达道路，恢复心肾水火阴阳的动态平衡，最终实现“水火既济、神安得寐”的治疗目标。

Based on the hexagram evolution theory of "Water and Fire in Harmony"(Ji Ji) and "Before Completion"(Wei Ji) from the Book of Changes, the theoretical foundation and diagnostic characteristics of eye acupuncture therapy for treating insomnia due to heart-kidney disharmony can be systematically explained. Traditional Chinese Medicine holds that the Ji Ji hexagram symbolizes the physiological norm of heart-kidney interaction, while the Wei Ji hexagram corresponds to the pathological state of heart-kidney dissociation. The core of this disharmony lies in the abnormal ascending and descending of the true yang in Kan(kidney) and the true yin in Li(heart). The harmonious interaction between the heart and kidney relies on the pivotal transportation and transformation of the spleen and stomach in the middle jiao, as well as the coordinated regulation of the liver and lung. According to the specific mechanisms of imbalance between water and fire, yin and yang, insomnia due to heart-kidney disharmony can be systematically categorized into the following four patterns: dysregulation between the supremacy and ministerial fire, with floating fire and cold water; deficiency of heart and kidney yang, leading to disorientation of the spirit; deficiency of water and excess of fire, failing to restrain upward disturbance; exhaustion of fundamental vitality, resulting in floating deficiency yang. Eye acupuncture therapy, centered on the principle of "Harmonizing Kan and Li", primarily selects the heart-small intestine area corresponding to the Li hexagram and the kidney-bladder area corresponding to the Kan hexagram within the Later Heaven Eight Trigrams division. By stimulating the true yang in Kan and nourishing the true yin in Li, it promotes the transformation from "Wei Ji" to "Ji Ji". Additionally, flexible combinations with areas such as the spleen-stomach, liver-gallbladder, and lung-large intestine are employed to strengthen the pivotal function, regulate qi movement, and unblock pathways. This restores the dynamic balance of water, fire, yin, and yang between the heart and kidney, ultimately achieving the therapeutic goal of "harmonizing water and fire, calming the spirit to restore peaceful sleep".