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47 岁女性患者，近三年起睡眠状况不稳定，时常躺很久不易入睡，有时候要躺 1-2
小时才入得着，但近一年症状更加严重，时常在床上煎鱼煎到快天亮才逐渐入睡，有时
候也会半夜醒，醒来之後往往就无法再入睡了。睡不好时，会出现夜间心悸、手部汗疱
疹等症状，也时不时有胃胀气，消化不良，便秘... 等问题。患者较喜食辛辣口味食物，
温饮，平时易焦虑，性子较偏急，也是个要求完美的个性，因此，较为容易焦虑，外观
皮肤色白皙，肤质细腻，舌质淡红，苔薄白，脉弦细。证以肝气郁滞，脾失运化，大肠
传导失职，治以疏肝理气，清肝泻火辅以通利大肠，处方以加味逍遥散、甘麦大枣汤及
龙胆泻肝汤，以及针刺调节星状神经节後症状逐步改善。
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A 47-year-old female patient has experienced unstable sleep patterns over the past three
years. She often lies awake for extended periods before falling asleep, sometimes taking 1-2 hours to do so. In the past year, her symptoms have worsened, with frequent insomnia episodes lasting until dawn, occasional nocturnal awakenings, and difficulty falling back asleep.Poor sleep quality is associated with symptoms such as nocturnal palpitations, hand sweating, and gastric discomfort, including bloating, indigestion, and constipation. The patient has a preference for spicy foods and warm beverages, and exhibits traits of anxiety, impatience, and perfectionism.
Physical examination reveals fair complexion, delicate skin texture, pale tongue with thin white coating, and thin pulse. TCM diagnosis suggests liver qi stagnation, spleen deficiency leading to improper digestion, and dysfunction of the large intestine. Treatment involves regulating liver qi, clearing liver heat, promoting bowel movements, and addressing symptoms with a combination of modified Xiaoyao San, Ganmai Dazao Tang, Longdan Xiegan Tang, and acupuncture targeting the autonomic nervous system. Symptoms gradually improve with the prescribed treatment regimen.
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【Keywords】 Insomnia, Liver yin deficiency, modified Xiaoyao San, Longdan Xiegan Tang, Acupuncture for autonomic nervous system disorders
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105.8 『自律神经失调之失眠』医案一则
