Senin, 16 Mei 2011

Acupuncture Treatment for Insomnia


Chief Complaint: insomnia
Western Diagnosis: insomnia.
Medical History: Insomnia for the last 18 months which started when the patient changed his job. He worked for 20 years doing shift work in the airforce, yet when he changed to a regular day job 18 months ago he started to suffer from insomnia. He used to get a maximum of 2 1/2 hours sleep each night. Sometimes he fell asleep easily and then woke up later on, and then was unable to get back to sleep. Other times it took him 2-3 hours to fall asleep and then he would wake up again and was unable to return to sleep.
He relaxed and walked the dog before going to bed. Very rarely had dreams. Very little alcohol, doesn’t smoke. Good diet; chicken, fruit, veg, little dairy. Last meal of the day was at 4.30pm. No coffee, 2 cups of tea daily.
He appeared very calm at the consultation. None of the usual patterns of disharmony within TCM stood out, such as; Heart Fire, Liver Fire, Blood deficiency, Liver Yin deficiency, etc.
Most significant symptom was the following :-
Thigh and calf muscle pain. “It feels like the muscles are twisted and knotted, very painful, like after running”. This started 18 months ago. The pain typically started three hours after getting out of bed and then lasted until he went back to bed. The pain was sharp when walking around and dull when sitting. The whole thigh was affected. His legs felt heavy, and they felt better when raised up.
Pulse exam: Pulse : left side thready, slightly rapid
right side thready
Tongue exam: Tongue slightly swollen, slight crack (transverse), some red prickles at the front and sides.
OM Diagnosis: Disharmony of the Yin Heel Vessel.
The Yin Heel Vessel is used in disturbances of sleep, either insomnia or somnolence. It addition to this, it is also used “in certain cases of Atrophy Syndrome”, to balance the tension of the inner and outer leg muscles. Although the patient did not have any Atrophy Syndrome, it was clear that opening the Yin Heel Vessel was the best approach since the only significant additional symptom was his leg pain.
Treatment Principle: Regulate the Yin Heel Vessel
Stop insomnia
Point Prescription: Kid6, Kid7, Bl2 – bilaterally
P6, Anmian, SP6 – formula for insomnia taken from Peter Deadman’s book (page 570)
No reducing or tonification methods were used.
Treatment was more effective late afternoon when Yin is raising.
Lifestyle Prescription: no changes to lifestyle necessary
Results: After five sessions this patient was completely curede of his insomnia. I phoned the patient two months later and he had no problems with sleeping.
Synopsis: Sometimes there is no obvious TCM diagnosis in terms of ‘patterns of disharmony’.
The Yin Heel Vessel is commonly used to regulate the Yin and Yang Qi going to the eyes. In this case it was particularly indicated since the only significant symptom was pain in his legs.

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