頑固性失眠病例報告暨中醫不寐典籍文獻回顧

A Case Study of Obstinate Sleeplessness and Review of Ancient Chinese Medicine Literatures and Textbooks about Insomnia

台灣地區睡眠問題、失眠問題的盛行率約為25%，西醫主要以抗憂鬱劑、抗組織胺及鎮靜劑等輔助睡眠，雖然安眠效果佳，然而相關的副作用促使越來越多的患者選擇其他替代療法來治療睡眠障礙。中醫無論從病因、病機、證治各個角度切入，都有其完整的理論與療效。本文以一例頑固性失眠病案為出發點，擬從古代不寐典籍文獻回顧中醫對於失眠的病因病機認識，後以本病案選方之柴胡加龍骨牡蠣湯、酸棗仁湯、溫膽湯為例，從古今醫家觀點，探討其用治頑固性失眠之療效機理。

The prevalence rate of sleep disorders and sleeplessness problems in Taiwan is around 25%. In western medicine, anti-depressants, antihistamines and tranquilizer are used to help sleep. These medicines have good effects on helping sleep, but more and more patients chose other replacement therapies to treat sleep disorders because of the medicine side effects. On the aspects of disease cause, pathogenesis and syndrome-treatment, traditional Chinese medicine has complete theories and treatment efficacy. Based on a case study of obstinate sleeplessness, we tried to review the cognition of traditional Chinese medicine to the disease cause and pathogenesis of sleeplessness from ancient literatures or textbooks. Finally, taking Caihujialonggumuli Decoction, Suanzaoren Decoction, and Wendan Decoction as examples, we studied the effect and pathogenesis of traditional Chinese medicine on treating obstinate sleeplessness through the viewpoints of ancient and modern physicians.