在终末期肝病进展过程中，肝硬化患者睡眠障碍发病率较高。目前西药治疗该病存在明显的肝肾损伤与停药后不良反应，影响其治疗效果。肝硬化与睡眠障碍可归属于中医学“积聚”与“不寐”范畴。“积聚”由肝脾气机逆乱，痰湿瘀血阻滞所致。在“积聚”发生发展中，肝失疏泄，脾失健运，肝阴肝血不足，脏腑阴阳失和，魂不守舍则外发为“不寐”。周 小舟教授以气血为本，指出肝硬化睡眠障碍的病机以肝郁脾虚为主，治疗以肝脾同调，兼调补心神为要，创制肝硬化安神方 （由香砂六君子汤化裁加减而成，由醋香附、砂仁、薏苡仁、山药、麸炒白术、鸡内金、栀子、党参、丹参、陈皮、茯神、龙眼肉、合欢皮、炙甘草共14味药物组成），临床疗效显著。 周小舟教授基于肝脾同调论治肝硬化睡眠障碍的临床经验可为中医临床治疗该病提供参考。

In the progression of end-stage liver disease，the incidence of sleep disorders in patients with liver cirrhosis is high. Currently，western medicine treatment has obvious liver and kidney damage and adverse reactions after discontinuation， which affects the therapeutic effect. Cirrhosis and sleep disorders can be separately attributed to the category of “abdominal mass” and “insomnia” in traditional Chinese medicine. The “abdominal mass” is caused by the disorder of liver and spleen qi movement，as well as the obstruction of phlegm-dampness and blood stasis. In the development of “abdominal mass”，the liver failed in ensuring free movement of qi，the spleen failed in transportation and transformation，liver yin and liver blood became insufficiency and the imbalance of yin and yang in the zang-fu organs became imbalanced，and then the ethereal soul depart from the housing，which leads to “insomnia” as an outward manifestation. Professor ZHOU Xiao-Zhou focuses on the concept of qi and blood，and points out that the pathogenesis of sleep disorder in cirrhosis is characterized by liver stagnation and spleen deficiency. He proposed that the treatment principle is to regulate the liver and spleen simultaneously，as well as to nourish the heart and calm the mind. Professor ZHOU has developed Ganyinghua Anshen Formula for treating sleep disorders in cirrhosis，which is derived from the modification of Xiangsha Liujunzi Decoction，and is composed of 14 Chinese medicines of vinegar-prepared Cyperi Rhizoma， Amomi Fructus， Coicis Semen，Dioscoreae Rhizoma ，bran-fried Atractylodis Macrocephalae Rhizoma，Galli Gigerii Endothelium Corneum， Gardeniae Fructus，Codonopsis Radix，Salviae Miltiorrhizae Radix et Rhizoma，Citri Reticulatae Pericarpium，Sclerotium Poriae Pararadicis，Longan Arillus，Albiziae Cortex，and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle. The formula has achieved remarkable clinical effect. The clinical experience of Professor ZHOU Xiao-Zhou for treating sleep disorders in cirrhosis through regulating the liver and spleen simultaneously will provide a reference for its clinical treatment with traditional Chinese medicine.

R256.23

国家自然科学基金面上项目 （编号：82374531）；国家自然科学基金青年项目 （编号：82205209）；深圳市科技计划项目 （编号：JCYJ20210324120405015）；广东省中医药局项目 （编号：20231302）