失眠之中醫診治

Diagnosis and Treatment of Traditional Chinese Medicine in Obstinate Insomnia

林展弘(Chan-Hung Lin)

《北市中醫會刊》 14卷4期 (2008/12) Pp. 11-20

https://doi.org/10.6718/TJCMb.200812_14(4).0004

摘要

失眠是指不能獲得正常睡眠為特徵的一種病症。表現為入睡困難，不能熟睡。有睡後易醒，醒後難以再入睡，有頻頻從夢中驚醒，自感整夜都在做夢，醒來仍不能消除疲勞，有甚至徹夜不眠。失眠會令人感覺疲勞，情緒不安，記性減退，反應遲鈍，也常與頭痛、頭暈、目眩、心悸等症同時出現，甚者導致精神失常嚴重影響身體健康、生活品質。
西醫治療失眠以服安眠藥為主；然長期服安眠藥，因耐受性和習慣性而致效果明顯降低，另外藥癮性、副作用，及停用會引起反跳性失眠，過量服用又致中毒而損害健康等問題，讓安眠藥的治療失眠存有缺憾。
失眠症即中醫文獻中之“不寐”中醫治療失眠，當分有邪與無邪、虛證與實證，及涉及臟腑不同進行辯証論治。虛証分心脾兩虛、陰虛火旺、心膽氣處。實証分痰熱擾心、肝郁化火、心火亢盛、食積胃脘；以補虛瀉實，調整陰陽、疏通經絡為原則，用耳尖放血、針灸、對症施藥標本兼治，能夠改善睡眠狀況，提高患者生活品質。

關鍵字

失眠 ； 不寐 ； 耳尖 ； 針灸 ； 辯証論治

並列摘要

Insomnia is a symptom of a sleeping disorder. It is characterized by persistent difficulty falling asleep, difficulty maintaining sleep, difficulty returning to sleep after awakening. Some people with insomnia complain of waking up frequently during the night and functional impairment while awake. Some insomniacs are unable to close their eyes all night. Daytime problems caused by insomnia include tiredness, emotional or mental tension, difficulty with memory, poor concentration and focus, headache, dizziness, giddiness, palpitation. Severe insomnia leads to psychological dysfunction and poor quality of health and life.
The primary mode of treatment in western medicine is to use sleeping pills. Tolerance-dependence developing to sleeping pills is a common feature following continuous administration of sleeping pills. Abrupt withdrawal from long-term usage of these drugs may produce rebound insomnia. Over dosage may cause intoxication and health- damage. These are defects of sleeping pills treatment.
Insomnia in traditional Chinese medicine means ”had sleep”. The treatment of Chinese medicine in insomnia can be classified into ”insomnia with pathogen” and ”insomnia without pathogen”, ”deficiency syndrome” and ”excess syndrome”, and ”syndrome differentiation and treatment depending on different Zang Fu-organs. Deficiency syndrome includes deficiency of both heart and spleen, yin deficiency fire excess. Heart gallbladder qi vacuity. Excess syndrome includes heart disturbed by phlemg-fire, liver depression transforming into fire, heart fire hyperactivity, and food retention and stomach pain. Reinforcing deficiency and reducing excess, regulating yin and yang, dredging the meridian are the treatment principles. With blood letting in ear apex, acupuncture-moxibustion, symptomatic treatment, and treating both the principal and secondary aspects, the sleep state and life quality can be improved.

並列關鍵字

Insomnia ； bad sleep ； ear apex ； acupuncture ； syndrome differentiation and treatment