Use of Traditional Chinese Medicine to Treat Circadian Rhythm Disturbance in an Elderly Patient with Dementia: A Case Report

中藥改善老年失智症的晝夜週期紊亂：個案報告一例

蕭坤元(Kun-Yuan Hsiao) ； 譚宏斌(Hung-Pin Tan) ； 歐陽文貞(Wen-Chen Ouyang)

《醫學與健康期刊》 10卷1期 (2021/03) Pp. 135-141

摘要

Sundown syndrome, a circadian rhythm disturbance, is a common clinical problem in dementia. Herein, we report a case involving a patient with dementia with sundown syndrome who we treated using traditional Chinese medicine (TCM). An 87-year-old woman who had been diagnosed with dementia in 2008 started having increasingly obvious circadian rhythm disturbance in 2017. In December 2018 she started visiting a daytime care center daily and receiving TCM treatment weekly. At the TCM clinic was prescribed an herbal mixture for improving daily awareness and an herbal mixture as a hypnotic and mood stabilizer before sleep. The prescriptions were modified for 3 weeks as her symptoms changed. The duration of her nighttime sleep and daytime awareness both increased. Her circadian rhythm was restored and remained normal during a three-month follow-up period. We used TCM to successfully regularize sleep-wake problems in one elderly female patient with dementia and sundown syndrome.

關鍵字

Dementia ； Sundown syndrome ； Circadian rhythm ； Traditional Chinese medicine

並列摘要

日落症候群，或稱為晝夜節律紊亂，是失智症在臨床上的常見問題。我們在此提出一個案使用中藥治療日落症候群。一名自2008年以來患有失智症的87歲女性，並在2017年後逐漸出現了晝夜節律紊亂。自2018年12月以來，她一直住在日間照護中心並同時接受中藥治療：日間的處方可改善日常活力與意識，睡前的處方可在睡前作為催眠和情緒穩定劑。中醫師在前3週根據症狀調整處方，她的夜眠時間和白天意識程度持續改善。在三個月的追蹤期間內，她的晝夜節律已有明顯改善。此例有日落症候群的失智症患者使用中藥輔助調節日夜週期紊亂問題，並且獲得改善。中藥可能是失智症日落症候群的潛在候選療法。

並列關鍵字

失智症 ； 日落症候群 ； 晝夜節律 ； 中藥

參考文獻

Sado M, Ninomiya A, Shikimoto R, et al.: The estimated cost of dementia in Japan, the most aged society in the world. PloS One 2018;13:e0206508

Hebert LE, Weuve J, Scherr PA, Evans DA: Alzheimer disease in the United States (2010-2050) estimated using the 2010 census. Neurology 2013;80:1778-83.

Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E: Alzheimer's disease. Lancet 2011;377:1019-31.

Vitiello MV, Bliwise DL, Prinz PN. Sleep in Alzheimer's disease and the sundown syndrome. Neurology 1992;42: 83-93.

Khachiyants N, Trinkle D, Son SJ, Kim KY: Sundown syndrome in persons with dementia: an update. Psychiatry Investig 2011;8:275.