中藥治療失眠之病例報告──匹茲堡睡眠品質量表應用於臨床用藥及療效評估之探討

A Case Report of Insomnia Treatment with Traditional Chinese Medicine: Pittsburgh Sleep Quality Index for Clinical Use and Efficacy Assessment

本病例報告之患者因個性本易緊張焦慮，又投資失利導致情志不遂，進而產生失眠的症狀，因此前來中醫門診就診，經中醫四診及分析後，歸納為情志因素所致，經診察後給予中醫藥物治療，其睡眠狀況遂得改善。失眠，又稱為「不寐」，或稱為不得眠、不得臥，「失眠」一詞，首見於唐．王燾《外臺秘要》，而相關症狀之典籍記載則首見於《內經》，如《素問．診要經終論》：「冬刺春分，病不已，令人欲臥不能眠，眠而有見。」《傷寒六書》：「陽勝陰虛，則晝夜不得眠。若陰為陽所勝，故終夜煩擾不得眠也。」。失眠之證型有虛實之分，虛證包括心脾兩虛、心膽氣虛、心腎不交等等，多為氣血不足，神失所養所致；實證有肝鬱化火、痰熱內擾、宿食停滯等等，然而實證日久也可能轉為虛證，進而形成虛實夾雜之候。匹茲堡睡眠品質量表（Pittsburgh sleep quality index, PSQI）是目前國際上公認信度較高也最被廣泛使用之睡眠品質評量表，其內容可用來評估患者的睡眠狀態與睡眠品質，本病例中使用匹茲堡睡眠品質量表來評估患者的睡眠狀況，作為治療用藥之參考，並於治療後用以評估中藥治療之療效。 This is a report of a 65-year-old woman suffering from insomnia. The patient has nervous and anxious personality and was confronted with the pressure of investment dislocation. She seek medical advice to improve her sleep. Evaluating by the four methods of diagnosis, pressure and emotional maladjustment were attributed to the symptom. After a series of medication, she could finally sleep safe and sound. Insomnia, also known as sleeplessness, is a common clinical sleep disorder. Patient with insomnia may have difficulty falling asleep, or staying asleep for long enough to feel refreshed the next morning. According to the syndromeclassification of Traditional Chinese Medicine, insomnia can be divided into deficiency-syndrome and excess-syndrome, and should be treated separately with medication. The Pittsburgh Sleep Quality Index (PSQI) is one of the most commonly used retrospective self-report questionnaire that assesses sleep quality. The measure consists of 19 individual items and creating 7 components that produce one global score. In this article, the involvement of PSQI during clinical practice and its role to refine the prescription would be described in the discussion.

This is a report of a 65-year-old woman suffering from insomnia. The patient has nervous and anxious personality and was confronted with the pressure of investment dislocation. She seek medical advice to improve her sleep. Evaluating by the four methods of diagnosis, pressure and emotional maladjustment were attributed to the symptom. After a series of medication, she could finally sleep safe and sound. Insomnia, also known as sleeplessness, is a common clinical sleep disorder. Patient with insomnia may have difficulty falling asleep, or staying asleep for long enough to feel refreshed the next morning. According to the syndromeclassification of Traditional Chinese Medicine, insomnia can be divided into deficiency-syndrome and excess-syndrome, and should be treated separately with medication. The Pittsburgh Sleep Quality Index (PSQI) is one of the most commonly used retrospective self-report questionnaire that assesses sleep quality. The measure consists of 19 individual items and creating 7 components that produce one global score. In this article, the involvement of PSQI during clinical practice and its role to refine the prescription would be described in the discussion.