A 2-year case of multiple dreams and easy awakening cured by prescriptions-经方数剂治愈多梦易醒2年案

Patient: Li, female 58 years old

Main complaint: more dreams and easy to wake up for 2 years

History of present illness: difficulty falling asleep, dreaming and waking up for more than 2 years, waking up in the morning, unconsciousness during the day, dullness, fatigue and sometimes bitter mouth, unsatisfactory diet, and able to eat, stool color sometimes turns black, usually Afraid of heat, bad thoughts, irritable and irritable, in the past two months I have always felt aggrieved and depressed, my tongue is pale and the fur is white, my pulse is thin, and my pulse is heavy.

Chronic symptoms: dreamy and easy to wake up, fatigue in the morning, dizzy and unclear during the day, sometimes bitter mouth, poor diet, irritability, low mood, fine pulse, heavy pulse.

Pathogenesis: evil spirits pervade the triple burn, restlessness, and deficiency of yin and yang.

Fang Zheng dialectic: According to Article 107 of “Treatise on Febrile Diseases”: Eight or nine days of typhoid fever, the next one is full of anxiety, trouble urinating, delirium, heavy all over, and those who cannot turn are the master of Bupleurum and keel.

According to the outline of the six classics taught by the master: Shaoyin is a disease, and the pulse is subtle, but it is also for sleep.

Diagnosis: Chaihu plus Longgumuli Decoction Syndrome and Mahuang Fuzi Gancao Decoction Syndrome

Therapeutic Principles: Reconciliation of Shaoyang, Calm and Soothe the nerves, Warm and sweat slightly

Recipe: Bupleurum plus Longgu Oyster and Mahuang Fuzi Gancao Decoction

North Bupleurum 20g Scutellaria 10g Codonopsis 10g Qing Pinellia 10g Ginger 10g Jujube 10g Cassia twig 10g Raw keel 15g Section oyster 20g Raw magnet 10g Poria cocos 10g Cyperus rotundus 10g Turmeric 10g Ephedra 12g Heishun slice 15g Qianghuo 10g Licorice 15g

Granules 5 doses of water

note:

According to the patient’s dreaminess, easy awakening, and lack of relief in the morning, sometimes the mouth is bitter, the diet is not fragrant, and irritable. It belongs to the syndrome of Chaihu and Longgu and Oyster Soup, and because of the book written by Master Huang Huang mentioned: Chaihujia Dragonbone oyster may be a common remedy for the treatment of phobias and depression in ancient times. Can be seen as a mental tranquilizer. And because the patient considered elderly depression from the perspective of Western medicine, this prescription was chosen.

From the patient’s irritability, irritability, feelings of grievance, Ganmai Dazao Decoction should be used, but the patient still has trouble thinking and drowsiness during the day, the pulse string is thin, the foot pulse is heavy, and the feeling is in the category of Shaoyin disease. The ephedra and aconite licorice soup. However, at the moment when the patient took the medicine, he still had no confidence in his heart. He was worried that the patient would not be able to rest well at night. There is ephedra in this prescription. I am afraid that she will worsen insomnia at night. What should I do? We can’t let the patient bring it to her and then change her prescription. This will reduce the patient’s trust in us. Wait for the effect!

Five days later, the patient didn’t come again after taking the medicine, and I didn’t call back for a visit. I slowly forgot about it. A few days ago, an older man brought his daughter-in-law to see his grandson, and he said you when he came in. It looked good, so I came with my grandson again. After the patient left, our staff told me that this is the old lady who was depressed that time. She is now much better. It depends on the situation. If she is not good, she He won’t take his grandson to see a doctor again.

Author: Zhu Hongxia

患者:李 女 58岁

主诉:多梦易醒2年

现病史:入睡困难,多梦易醒2年余,早晨起来不解乏,白天头脑不清,昏昏沉沉,没劲乏力有时口苦,饮食不香,也能吃下去,大便颜色有时发黑,平时怕热,好想事,烦躁易怒,最近两个月老是感觉委屈情绪低落,舌淡苔白,脉弦细数,尺脉沉。

刻下症:多梦易醒,晨起乏力,白天昏昏沉沉头脑不清,有时口苦,饮食不香,烦躁易怒,情绪低落,脉弦细数,尺脉沉。

病机:邪气弥漫三焦,心胆不宁,少阴阳虚。

方证辩证:根据《伤寒论》第107条:伤寒八九日,下之,胸满烦惊,小便不利,谵语,一身尽重,不可转则者,柴胡加龙骨牡蛎主之。

又根据师父所讲六经提纲:少阴之为病,脉微细,但欲寐也。

诊断:柴胡加龙骨牡蛎汤证 麻黄附子甘草汤证

治则:和解少阳,镇静安神,温经微汗

方药:柴胡加龙骨牡蛎合麻黄附子甘草汤

北柴胡20g 黄芩10g 党参10g 清半夏10g 生姜10g 大枣10g 桂枝10g 生龙骨15g 段牡蛎20g 生磁石10g 茯苓10g 香附10g 郁金10g 麻黄12g 黑顺片15g 羌活10g 甘草15g

颗粒剂5剂水冲服

按语:

根据患者多梦易醒,晨起不解乏,有时口苦,饮食不香,烦躁,属柴胡加龙骨牡蛎汤证,又因师父所发的书上编著提起黄煌老师所说:柴胡加龙骨牡蛎可能是古代治疗恐惧症、抑郁症的常用方。可以看做精神镇静剂。又因该患者从西医角度考虑属于老年抑郁,故选此方。

从患者烦躁易怒感觉委屈应该选用甘麦大枣汤,但是患者还有白天头脑不清昏昏沉沉,脉弦细数,尺脉沉,感觉又符合少阴病的范畴,考虑半天最后还是选择了麻黄附子甘草汤。不过当时患者拿走药的那一刻,心中还是没有底气,担心患者本来晚上就休息不好,此方里面有麻黄,恐怕她晚上再加重失眠,怎么办?不能再让患者拿来再给她改方子吧,这样一来会给患者心中降低了对我们的信任度。还是等待效果吧!

五天后患者服完药后也没再来,我也没打电话回访,慢慢的就把这个事儿给忘了,前几天有个年长着带着儿媳来给孙子看病,进门就说你看的很好,所以又带着孙子来了,患者走后我们的员工告诉我,你看这是那次那个抑郁的老太太,现在精神好多了,看情况应该是好了,不好的话她不会又带孙子来看病。

作者:祝红霞

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