失眠合併停經後症候群之中醫療法病例報告

Reatment of Insomnia with Postmenopausal Syndrome Using Traditional Chinese Medicine

連怡鈞(Yi-Chun Lien) ； 林舜穀(Shun-Gu Lin) ； 陳朝宗(Chao-Tsung Chen) ； 鍾靜怡(Ching-Yi Chung)

《中醫內科醫學雜誌》 10卷1期 (2012/06) Pp. 50-63

https://doi.org/10.7102/JTCIM.201206.0050

摘要

臨床上失眠有多種型態的表現，中醫將病因分為虛、實二證：虛證多因虛煩勞心、情志抑鬱，常以淺眠易醒、善驚多恐表現；實證者多因飲食不節、情緒易怒、煩躁多思，失眠多以難以入眠，伴隨口乾口苦的狀況。西醫治療以苯二酚類Benzodiazepine(BZD)、stilnox類及抗憂鬱劑等鎮靜安眠藥物為主，中醫則依不同證型表現辨證論治，試圖提供較為精確且符合個人化的治療，並且避免安眠藥長期服用的副作用及成癮性。本病案提出中醫門診治療一位55歲婦女，在5年前停經後，出現持續的失眠，且就診前數日難以成眠及淺眠的情況加重，同時有容易作惡夢，且因盜汗嚴重而驚醒。本病案治療過程中以睡眠日記（sleepdiary）客觀地記錄患者的睡眠狀況，並以中醫方藥配合針灸、耳珠貼穴治療。經過一個月的治療後，難入眠的狀況改善，且淺眠天數及作惡夢天數亦有減少，顯示中醫在臨床治療睡眠障礙確有其成效。

關鍵字

失眠 ； 不寐 ； 停期後症候群 ； 睡眠日記 ； 耳珠

並列摘要

Chinese medicine took insomnia part in deficiency and excess, the deficient insomnia usually caused by anxiety, depression, difficulty staying asleep, terrify in midnight. Excessive insomnia is usually caused by irregular diet, irritable temper, restlessness and anxiety. It often performs difficult falling asleep, combined with dry and bitter mouth. Compared that modern medicine use Benzodiazepine (BZD), stilnox sleeping pills and anti-depressant agents to treatment insomnia identically, Traditional Chinese Medicine used the concept of differentiation of diagnosis and treatment to approach insomnia, and TCM has no side-effect and addiction of long-term use of sleeping pills. We present a case of 55-year-old post-menopausal woman, who had insomnia. She was difficult to falling sleep, maintain sleep, and became worsened recently and easily to woke up due to nightmares and night sweats. We record the patient's sleep situation using the sleep diary and treatment the case using Chinese herbs, acupuncture, and ear needles. After a month of treatment, the situation of difficulty falls asleep and difficulty maintaining sleep was improved, and nightmares also reduced. It appears that Chinese medicine combining acupuncture and ear needles treatment insomnia efficient in clinical.