Patient Treatment Process
Mr. Li, the patient, has been troubled by chronic insomnia and tinnitus. Since childhood, he has been prone to excessive worry and difficulty falling asleep. He has never felt well-rested for a long time. Pulse examination reveals a weak and short pulse on the right side and a thin, slippery, and wiry pulse on the left. His tongue coating is pale red and thin white. Based on the overall assessment, it is determined that the patient has long-term deficiency of both Qi and blood, accompanied by liver qi stagnation. The treatment primarily focuses on improving sleep, with a prescription of Sheng Yu Tang to nourish Qi and blood, combined with Xiao Chai Hu Tang to soothe the liver and resolve stagnation, augmented by Gou Teng to enhance liver-calming effects.
During the course of treatment, the patient’s symptoms of insomnia and tinnitus gradually improved. After five weeks of treatment, the patient’s sleep onset time shortened, and he experienced a sense of deep sleep, with tinnitus occurring infrequently.
Definition and Causes of Insomnia
Many people suffer from chronic insomnia, which can manifest as difficulty falling asleep, difficulty staying asleep, early awakening, or feeling unrefreshed upon waking, leading to insufficient overall sleep time or poor sleep quality. Modern lifestyles, characterized by a fast pace and high stress, often contribute to insomnia, as do habits such as drinking coffee, tea, or using smartphones before bedtime. Chronic or acute illnesses can also disturb sleep.
From the perspective of traditional Chinese medicine (TCM), insomnia can result from imbalances in Yin and Yang, Qi and blood, or dysfunction of internal organs. Common TCM patterns include liver qi stagnation related to stress, heart Yin deficiency or non-coordination between heart and kidney due to excessive mental exertion or prolonged sleep deprivation, and phlegm-heat due to greasy diet. Given the variability in dietary habits and irregular lifestyles, a patient may exhibit multiple patterns simultaneously, necessitating careful differentiation by a TCM practitioner to prescribe the most suitable treatment regimen.