ZHANG Zhen's Experience in Treating Perimenopausal Insomnia Based on the Ziwu-Liuzhu（Midnight-Noon Ebb-Flow）Theory
10.13288/j.11-2166/r.2026.21.003
- VernacularTitle:张震基于子午流注理论治疗围绝经期失眠经验
- Author:
Jianping ZHU
1
;
Yuyao YANG
1
;
Chunhong TIAN
2
;
Tianwu ZHANG
1
Author Information
1. Pu'er Hospital of Traditional Chinese Medicine，Yunnan，665000
2. Yunnan Institute of Traditional Chinese Medicine and Materia Medica
- Publication Type:Journal Article
- Keywords:
perimenopausal insomnia;
Ziwu-Liuzhu （midnight-noon ebb-flow）;
soothing and regulating qi and calming the mind;
experience of famous doctors;
ZHANG Zhen
- From:
Journal of Traditional Chinese Medicine
2026;67(21):2270-2274
- CountryChina
- Language:Chinese
-
Abstract:
This article summarizes professor ZHANG Zhen's clinical experience in treating perimenopausal insomnia using the method of soothing and regulating qi and calming the mind， based on the Ziwu-Liuzhu（midnight-noon ebb-flow） theory. The basic pathogenesis of the disease is considered to involve dysregulation of qi movement and disturbance of the circadian rhythm of yin and yang. Shutiao Anshen Decoction （疏调安神汤） is taken as the basic formula， with modifications guided by the zang-fu （脏腑） organ time correspondence of the Ziwu-Liuzhu theory. Based on the temporal characteristics of insomnia， the condition is classified into three patterns for syndrome differentiation and treatment， including difficulty falling asleep at night， awakening during the middle of the night， and early-morning awakening. Difficulty falling asleep at night tends to occur around the transition from the Hai （亥） hour to the Zi （子） hour. Its pathogenesis is characterized by liver constraint and qi stagnation， with yang failing to enter yin. Treatment should focus on soothing the liver， facilitating the pivotal movement of qi， and guiding yang into yin. For cases dominated by qi stagnation， Shutiao Anshen Decoction （疏调安神汤） may be supplemented with herbs that promote qi movement； for cases with constraint heat， heat-clearing medicinals may be added. Awakening during the middle of the night commonly occurs during the Chou （丑） hour， when the liver channel is predominant. The underlying pathogenesis is liver channel constraint-heat disturbing the Hun （魂） and impairing its anchoring. Treatment should clear liver heat， calm the hun， and tranquilize the mind. Mild cases may be treated with Shutiao Anshen Decoction combined with liver-calming medicinals， whereas severe cases may require formulas that clear liver fire and settle the mind with heavy tranquilizing medicinals. Early-morning awakening commonly occurs during the Yin （寅） hour， when the lung channel is predominant. Its pathogenesis involves lung-spleen-kidney deficiency， resulting in failure of qi to contain yang. Treatment should fortify the spleen， tonify the kidney， replenish qi， restrain yang， and concurrently eliminate residual pathogenic factors. For Lung-spleen qi deficiency， Shutiao Anshen Decoction may be supplemented with qi-tonifying medicinals； for kidney yin deficiency， yin-nourishing medicinals may be added.
