Monday, May 2, 2011

Acupuncture Case Studies - Treatment of Insomnia



Chief-complaint: Insomnia
Western-diagnosis: Insomnia
Medical-history:
Symptoms: Insomnia with racing thoughts, worry, tossing & turning during her few hours sleep, fatigue, poor memory, & anxiety.
Pulse: Thready, slightly rapid
Tongue: Pale slightly Thin, w/slight white coating in middle jiao.
CM-diagnosis: Insomnia due to Heart & Spleen Deficiency
Treatment-principle: Supplement the Heart and Spleen to promote the production of Blood and Qi
Point-prescription: Initial Acupuncture:
Front: Ht 7, Sp 6, An Mian, GB 20, Kid 6, UB 43, UB 20, Du 20
Auricular: Shen Men, Sympathetic
Herbs: Gui Pi Tang 5:1, 5ml 3x daily
Upon Reviewing Practical Therapeutics of TCM, I decided to use only the auxiliary points, Du 20, UB 52 & Si Shen Cong. I also discontinued the Gui Pi Tang.
Herb-prescription: Herbs: Gui Pi Tang 5:1, 5ml 3x daily
Discontinued after reassessment during third visit.
Lifestyle-prescription: Avoid vigorous exercise after 5pm and stimulating mental activities after 8pm. Try to avoid heavy or spicy food at night as well. Do not work or watch TV in bed. Use your bed for sleeping only.
Results: At first glance, this seemed to be a very easily treated condition. Unfortunately, the patient was unresponsive to the first three treatments.
Upon Reviewing Practical Therapeutics of TCM, I decided to use only the auxiliary points, Du 20, UB 52 & Si Shen Cong. I felt that I while the condition was accurately diagnosed as a Heart/Spleen deficiency pattern, the treatment should focus on WHERE the symptoms manifest, in the head. I discontinued the Gui Pi Tang for the same reason.
The following day, the patient called to tell me that she finally had a decent night’s sleep. I treated her 8 more times with Si Shen Cong, Du 20, and UB 52. Patient went from 3-4 hours of fit-full sleep to 6-7 restful hours per night. Her fatigue resolved and her memory improved.

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