Name: Ms. K      Ages: 50

Chief Complaint: Insomnia for 2 years, aggravated for 2 weeks

Clinical manifestations: The patient suffers from insomnia for 2 years, she use to take sleeping pills, 2 weeks ago her son got the first scholarship from his university and this made her very happy, However, her sleep is getting worse thereafter, she also has restlessness, palpitation, dizziness, tinnitus, poor memory and lumbar soreness, a hot sensation in the palms, soles and chest, thirst, red tongue body with scanty coating, thin and rapid pulse.

Diagnostic conclusion   

   TCM disease: Insomnia

   TCM type/pattern: Disharmony between of Heart and Kidney

Classify patient’s condition

  (          ) Patients condition is classified according to the Fundamental substances

  (    v    ) Patients condition is classified according to the Zang Fu

  (         )  Patients condition is classified according to Jing Luo

  (    v   )  Patients condition is classified according to aetiology

According to the eight-principle syndromes

     Aetiology                               According to condition                   eight-principle syndromes

   Internal (emotional factors)    over joy, HT-qi hyperactivity          yin interior, Heat, deficient

   Shanghan                                      Shaoyin Heat syndrome

Explanation

  Insomnia for 2 years (58 yrs.) - chronic illness and maybe def. of zhangfu function (interior)

  Over joy cause hyperactivity of HT qi.

  HT/KI shaoyin Heat - Kidney yin def. fail to nourish Heart yin cause hyperactivity of HT - yang, def. Of HT blood restlessness, palpitation, dizziness, tinnitus, poor memory and lumbar soreness.

  Def. heat(interior) -a hot sensation in the palms, soles and chest, thirst, red tongue body with scanty coating, thin and rapid pulse.

Treatment Principle

          Nourish KI and HT yin, clear def. Heat, harmonize KI/HT, calm mind

Explain the rationale for treatment according to TCM principles

          Shaoyin heat due to yin def. so that to nourish KI and HT yin can replenish yin to clear def. heat, harmonize KI/HT and calm mind to treat insomnia accompanied with others symptoms such as restlessness, palpitation, dizziness, tinnitus, poor memory and lumbar soreness.

Select points and relevant function and indications of each point relevant to the treatment principle listed above

1.       Taixi (KI 3)- Yuan& Shu point of KI-Meridian, to nourish yin to clear def. fire to treat dizziness,  tinnitus, poor memory and lumbar soreness.

2.       Zhaohai (KI 6) - eight confluent points, to nourish KI yin to clear def. fire.

3.       Yinxi (HT 6)- Xi-cleft point to tranquilize the mind.

4.       Shenmen (HT 7) - Yuan-Source& Shu-Stream point of HT-Meridian; slowing down the heart rate and calming the mind.

5.       Neiguan (PC 6) - eight confluent points (PC and Yinwei channel) and luo point of PC channel, to calm mind.

6.       Sanyinjiao (SP6) nourish yin of LV, KI, SP, harmonises the lower Jiao, calm spirits.

7.       Baihui (DU 20) - all yang channel converge point, smooth qi flow to calm mind.

Conclusion:

  Insomnia due to interior def. Heat disturb mind, accompany with restlessness, palpitation, dizziness, tinnitus etc., apply with mix point of channel of HT, KI, SP, PC, DU to nourish yin to clear def. heat and harmonize HT/KI to calm mind.

  All points forcus to nourish yin to clear def. heat and balance HT/KI to calm mind to improve the patient’s condition

(a) Treatment technique intended

  Reforming methods to clear def. heat 

  Even method to calm mind

(b) Function of channels involved

  DU channel: calm mind

  Shaoyin HT/KI Channel, nourish yin, clear def. Fire, regulate HT qi to calm mind

  PC channel -regulate HT qi, calm mind

Ø SP channel, nourish yin of LV/SP/KI channel to clear clear def. Fire