柴胡疏肝湯治療失眠症之案例報告

The Case Reports on Chinese Medicine Treatments for Insomnia

失眠是一種常見疾病，在台灣有睡眠障礙的人口依台灣睡眠醫學學會2009年統計盛行率達21.8%，保守估計超過400萬人，已較2006年11.5%倍增。失眠症會造成注意力不集中，記憶力減退，判斷力和日常工作能力下降，嚴重者合併焦慮、強迫、抑鬱障礙；失眠還是造成冠心病和糖尿病患的危險因素，因此失眠治療對人們的身心健康十分重要。文中藍吳女士及鄭女士兩例不眠症，符合不寐症中西醫診斷標準，是依匹茲堡睡眠品質量表（Pittsberg Sleep Quality Index psqi）評量後，根據中醫辨證、病因病機分析及中醫理法方藥分析之後，採用平肝解鬱活血安神，以柴胡疏肝湯隨證加減柴胡桂枝湯、天王補心湯等，PSQI分別從20減至6，及14減至6，大幅改善睡眠狀況，獲得良好療效，而且不會有健忘疲勞，腸胃不適，口乾胃覺改變等副作用，不但安眠藥量減少甚至不需再服用；且入睡時間縮短至10－20分鐘內，主觀覺得睡眠良好，不會提早醒來，睡眠時間恢復正常或夜間睡眠時間增加至6h以上，睡眠深沉、醒後精神充沛。白天工作清醒不會打瞌睡，效果良好。

Insomnia is a common disease. According to the statistics from the Taiwan Society of Sleep Medicine, the prevalence of sleep disorders in Taiwan was 21.8% of the population in 2009. It has been conservatively estimated that more than four million people suffer from sleep disorders, and that the prevalence of insomnia has doubled since 2006, when it was 11.5%. Insomnia leads to a lack of concentration and memory loss, as well as reduced judgment abilities and daily work productivity. People with severe symptoms of insomnia can also suffer from anxiety, obsessive-compulsive disorder, and depression. Moreover, insomnia is also a risk factor for patients with coronary heart disease and diabetes. Therefore, the accurate diagnosis and treatment of insomnia are very important for the physical and mental health of people (10). The two subjects of this study met the diagnostic criteria of insomnia for both Chinese and western medicine. After being assessed with the Pittsburgh Sleep Quality Index (PSQI), they received treatment with Chinese medicine, namely Bupleurum and Cyperus Combination, along with different dosage of Bupleurum and Cinnamon Combination, as well as Ginseng & Zizyphus Combination, to promote blood circulation and soothe the nerves. The patients' PSQI scores decreased from 20 to 6 and from 14 to 6, respectively. Their sleep condition was significantly improved, and the efficacy was good. Moreover, they did not experience side effects such as amnesia, fatigue, gastrointestinal discomfort, thirst, or changes in taste. The dosage was reduced until the patients no longer needed to take the medication, and the time required to fall asleep was reduced to 10-20 minutes.