中醫藥治療睡眠障礙病例報告

A Case Report of Sleep Disturbance Treated with Traditional Chinese Medicine

現代社會步調繁忙，生活緊張，許多原本已於西醫身心科規律就診以及 治療的病友，因為生活突如其來，令人措手不及的偶發事件，所造成的壓力， 而又加重其夜間睡眠障礙，導致白天精神不濟，怔忡怵惕心慌感，甚者臨事 易驚，影響其他基本生活功能，例如進食與消化等症狀。因此，臨床上不少 病友除了規律就診西醫精神科以外，亦嘗試求助於中醫。身為訓練有素的中 醫執業醫師，針對此類睡眠障礙的案例，除了要搞懂睡眠在西醫的生理學原 理之外，清楚地分辨常用西醫精神科藥物（含西醫安眠藥）的西藥藥理作用， 臨床上仔細辨證病人睡眠障礙的證型，在配合原本的白天西醫精神科藥物治 療的前提之下，審慎選取中醫中藥介入的時機，並且仔細追蹤中藥療效，再 評估治療睡眠障礙時，在西醫白天的精神科藥物依然持續治療的情況之下， 其西醫夜間安眠藥服用的減少情形，為中西醫聯合治療睡眠障礙的病友開一 扇窗。

In the hustle and bustle modernized society, many psychotic patients who has been under regular treatment in psychiatric clinic, would get their sleep disturbance worsening, if unexpected major event occurred. It may result in daytime low spirit, frequent nervousness, and even other basic physiological function disturbance, such as having a meal or digestion. Therefore, other than under regular medicine in psychiatric clinic, many patients would also refer to traditional Chinese medicine department, or seek kampo medicine. As a professionally-trained traditional Chinese medicine practitioner, in addition to figure out sleep physiology and the pharmacology of those psychiatric medicine, we also have to carefully distinguish the type of sleep disturbance under traditional Chinese medicine. It may be our priority to pick up the appropriate opportunity for the intervention of TCM medicine, and track its effect. It would be our progress to decrease the dosage of sleeping pills at night, even if the daytime regular psychiatric medicine still the same. It was the road less travelled in the past, but would be necessary in the future to integrate psychiatric medicine with traditional Chinese medicine in the treatment of sleep disturbance.