調暢樞機以治療失眠之病例報告

A Case Report of Insomnia Treated with The Mediation of Channels

樞機的論述最早可追溯到《內經》，《素問．陰陽離合》篇：“太陽為開，陽明為闔，少陽為樞。”但少陽樞機之實質內容是於《傷寒論》少陽病柴胡證的論述中提出的，《傷寒論》以“口苦，咽乾，目眩”作為少陽病的提綱證候，就是對樞機失調臨床症狀的觀察。本案例為一名51歲的女性，半年前因為罹患登革熱(Dengue fever)後開始反覆失眠，隨後夜晚需服用安眠藥Ativan 1mg始可入睡。治療時先給予小柴胡湯調暢氣機後，使氣機出入正常，升降自如，開闔有度，再投以消瘰丸，處理痰熱造成的不寐，於病人服藥4個月後（治療第14次後）病情有明顯改善。

＂Channels＂ can be traced back to ＂Nei-Ging＂, and the ＂opening-closing-pivoting ＂theory was stated in ＂Suwen-Yingyang Lihe＂. However, ＂Channels＂ of Shao Yang is actually based on Chaihu syndrome in ＂Shang Han Lun＂. The main Shaoyang symptoms consist of mouth-bitterness, throat-drying and eyes-dazzling, which are the clinical observations of ＂Channels＂ disorder. This case is a 51-year-old female, she has to take Ativan 1mg every night for helping sleep for six months after dengue fever. She worried about drug addiction, so came to us wishing to withdraw Ativan. We tried Xiao Chai Hu Tang. As ＂Qi＂ was regulated and futherly normalized, after 14 course of treatment in four months, her sleeping problem has been very much improved. Xiao Lei Pill was used as well, because ＂Phlegm-Heat＂ can be a factor induicing insomnia too.