A Preliminary Discussion on “Disordered Stomach Leads to Restless Sleep” and Clinical Insights

文章基于《内经》“胃不和则卧不安”理论，系统探讨其病因病机，认为脾胃失和可通过气机逆乱、痰火扰心、气血失养及肝胃失调等途径导致失眠。通过两则典型医案(脾胃虚弱型与肝脾不和型失眠)的临床实践，验证了“从胃论治”失眠症的有效性。治疗以调和脾胃为核心，灵活运用健脾益气、消食导滞、清胃泻火、平肝和胃等法，并辅以安神宁心药物，结合饮食调护，显著改善患者睡眠质量及伴随症状。研究强调，临床诊治失眠应重视脾胃功能状态，辨证施治以恢复中焦气机升降，为“胃不和则卧不安”理论提供了实践依据。Based on the theory of “disordered stomach leads to restless sleep” from The Yellow Emperor’s Inner Canon (Huangdi Neijing), this paper systematically explores its etiology and pathogenesis. It posits that spleen-stomach disharmony can induce insomnia through mechanisms such as reversed qi movement, phlegm-fire disturbing the heart, insufficient nourishment of qi and blood, and liver-stomach dysfunction. Through clinical practice involving two typical medical cases (insomnia due to spleen-stomach deficiency type and liver-spleen disharmony type), the effectiveness of “treating insomnia from the stomach perspective” was validated. The treatment focuses on regulating spleen stomach function, flexibly employing methods such as fortifying the spleen and boosting qi, promoting digestion and resolving stagnation, clearing stomach heat and purging fire, pacifying the liver and harmonizing the stomach, supplemented with sedative and heart-calming herbs, combined with dietary adjustments. These approaches significantly improved patients’ sleep quality and alleviated accompanying symptoms. The study emphasizes that clinical diagnosis and treatment of insomnia should prioritize the functional state of the spleen and stomach, applying syndrome differentiation to restore the ascending-descending mechanism of middle-jiao qi. This provides practical evidence supporting the theory that “disordered stomach leads to restless sleep”.