婦女失眠從肝論治醫案報告

A Case Report from the Liver on the Treatment of Woman’s Insomnia

失眠是現代的常見疾病之一，且會影響病患的生活品質及日常生活功能。西醫治療失眠的藥物主要為抗憂鬱劑、抗組織胺及鎮靜劑等，雖然療效顯著，但卻有可能產生副作用，因此許多患者轉向其他替代療法來治療失眠，中醫即為選項之一。除了中藥治療外，衛教也是提高病患睡眠質量的治療方式。根據健保資料庫的統計分析發現，台灣失眠患者常見的中醫證型多為肝、心兩臟的問題，與大陸所出版的教科書略有不同。本病例即為因情志導致肝失疏泄而失眠的病患，在中醫介入之前一天只能睡2-3小時，因此從肝論治，處方以加味逍遙散為主，並加上適當的衛教，在一個月的治療後病患已無失眠症狀。

Insomnia is a common health problem in the general population worldwide, and is associated with life quality and personal functioning in daily living. Drugs included anti-depressants, antihistamines and sedatives are used to help sleep. These drugs are effective, but accompanied by side effects. Patients chose other replacement therapies such as Chinese medicine to treat insomnia. In addition to medicine, sleep hygiene is believed to promote improved quantity and quality of sleep. By analyzing the National Health Insurance(NHI) database, we found the common pattern types are slightly different from China books, and most patients suffered insomnia due to liver and heart problem in traditional Chinese medicine sight. This was a woman who had suffered from insomnia for six months on account of failure of the liver's free coursing. Therefore, the patient had been treated by Jia-wei-xiao-yao-san and appropriate sleep hygiene. The patient had no symptom after one month of regular Chinese-medicine taking.