In daily diagnosis and treatment in Hong Kong, patients often encounter insomnia and systemic disorders and distress due to anxiety, which seriously affect their own and family life. The following cases left a deep impression on me. Case patient of "ghost pressing on the bed": fe

In daily diagnosis and treatment in Hong Kong, patients who are often faced with insomnia and systemic disorders and distress due to anxiety, which seriously affect their own and family life. The following cases left a deep impression on me.

"Ghost Pressing the Bed" case

Patient: female, 35 years old. Initial diagnosis: October 13, 2014 Main complaint: Insomnia for many years and dreaming at night. Medical history: grew up in Hong Kong, but lived in Singapore for many years and returned to Hong Kong for childcare after giving birth 2 years ago. Because I was ill, I started to believe in religion when I was in Singapore. I firmly believe that the cause of my sleep disorder was caused by the wizard . I have many dreams at night, and often have sneaks to suppress my body and sexually assault me ​​(nightmare, dream sex), so I dare not fall asleep, which leads to difficulty falling asleep. Although I have been treated with many methods, Chinese and Western medicines and acupuncture for several years, my insomnia has not been eliminated and it is difficult to get insomnia. If you don’t have enough sleep at night, take a nap to make up for it, which will lead to a reversal of day and night. I feel upset all day long and restless. The abdominal distension is common, and there are many symptoms of belching and bitter mouth. There is a diagnosis of esophageal reflux. The stool is irregular at all times and diarrhea is often caused. In the past six months, I have suffered from pain in the left sole and close to the heel. Diagnosis and examination : Short and fat, with no abnormal expressions. Talk more and speak fast. The tongue is fat and big but light, the coating is thin and white, and the pulse is deep and is small and smooth. There is obvious tenderness in the front edge of the left sole of the calcane.

nightmare is a temporary physical paralysis accompanied by nightmare, commonly known as "ghost pressing on the bed". I suddenly had hallucinations and fear, and my body could not move and could not speak.

My diagnosis and treatment is as follows:

.Insomnia , 2. Depression

syndrome differentiation: gallbladder phlegm disturbance, liver and stomach qi reversal, mind and mind loss

It is speculated that the diagnosis of Western medicine's disease name should include sleep paralysis, anxiety disorder, gastroesophageal reflux,

functional indigestion, irritable bowel syndrome, and plantar fasciitis .

Treatment rules: Relieve the liver and gallbladder, resolve phlegm and harmonize the middle, calm the heart and calm the nerves

Treatment: Traditional Chinese Medicine + Acupuncture + Cognitive Therapy

① Traditional Chinese Medicine: Guizhi Jialonggu Muli Decoction and Wendan Decoction with addition and subtraction.

②Acupuncture: Baihui, Sishencong, Neiguan , Zhongwan, Tianshu , Zusanli , Yanglingquan , Fenglong, Taichong , etc. For pain in the left soles and close to the heel of the left soles, the pain point is used as the acupoint, and the fine needle is directly inserted to keep the needle.

③Cognitive therapy: patiently explains to patients the different views on "ghost pressing on the bed" and "dream communication" between traditional Chinese medicine and its religious views, and informs the patient that as early as 1800 years ago, Zhang Zhongjing's era, traditional Chinese medicine was already using prescriptions that can treat her symptoms; at the same time, it informs the patients that the complex and colorful symptoms are actually induced or aggravated by their restlessness. In this way, gradually shake and change the patient's wrong perception of his own diseases, and prompt him to "transfer the essence and change the qi" (improve cognition and mentality).

Second diagnosis: October 20, 2014.

condition: patients are happy to complain that taking traditional Chinese medicine to improve sleep in other places often worsens gastrointestinal symptoms. However, the abdominal distension and bitter mouth have been reduced in the past week, and the bowel movements are normal. The number of nightmares is reduced, the feeling of restlessness is reduced, and the pain in the heel of the left soles is also relieved. Check the tongue and pulse as before, and the prescription is not correct. The previous plan is used to treat it.

Third diagnosis: November 3, 2014.

Symptoms: Abdominal symptoms fluctuate with changes in sleep state, still have bitter mouth, pantothenic acid, and mild abdominal distension. The mood is calmer than before, and the number of nightmares has decreased significantly. The tongue is fat and big and light, the coating is thin and white, and the pulse is deep, thin and slippery. Slight tenderness in the front edge of the left sole of the calcane. Treatment prior to succession.

Results: months later, the patient introduced his mother to the diagnosis. Hearing from his mother, the patient has been in a state of discomfort and suspicion for several years, which has caused the family to be restless. However, after receiving treatment at the author, his mental and physical condition has become increasingly stable, and has improved greatly.

Diagnosis:

Cognitive therapy for "ghost pressing the bed"

The main complaint of this patient was sleep disorder, and the main problem was nightmare and dream intercourse. Nightmare is a temporary physical paralysis accompanied by nightmares, commonly known as "ghost pressing the bed", and modern Western medicine calls it "sleep paralysis".

More than 70% of sleep disorders are secondary, and the causes are mostly related to mental and psychological factors. Insomnia in this patient occurred with anxiety disorders (disturbance, restlessness, and multiple consultations), as well as psychosocial diseases such as gastroesophageal reflux, functional indigestion, irritable bowel syndrome, plantar fasciitis, etc. The proliferation of the disease is linked to the patient's own religious concepts about the cause, which is mainly "heart disease".

This type of patients often change to clinics or doctors due to anxiety and changing symptoms, and it is easy to have "go to visit medically". Therefore, establishing a good doctor-patient relationship in the initial stage and gaining the trust of patients is the prerequisite for ensuring the effectiveness of diagnosis and treatment.

Cognitive mindset and ideas dominate actions. If you want to cure depression, you should attack your heart and become the best. Therefore, while using acupuncture and medicine for this patient, the author attaches importance to the application of cognitive therapy. During each diagnosis and treatment, he uses the principles of traditional Chinese medicine to correct his paranoid concepts of ghosts and gods, and regulates the mental state of the patient, and attempts to change his mental and physical state of qi and blood disorder. This is the operation of "transferring essence and turning qi" by adjusting cognition.

It is very important to understand the reason through consultation and conversation, and to adjust the patient's cognition and concepts.

heel pain is also often related to heart

Finally, let me mention the psychological and physical diagnosis and treatment of plantar fasciitis in this patient with heel pain as the main symptom. Because "the kidney controls the waist and feet", the cause of heel pain is often generally attributed to kidney deficiency according to traditional theory. However, for some young and middle-aged patients, in addition to the symptoms of heel pain, it is difficult for traditional Chinese medicine to see other clues about kidney deficiency in patients.

In fact, modern research shows that similar to headache, neck and shoulder pain or low back pain, stomach pain, abdominal pain and other pain, emotional and psychological factors such as anxiety, depression, and tension are likely to cause muscle tension, stiffness, and spasm of . If you are under the influence of such emotions for a long time, you are also prone to suffering from myofascial pain symptoms such as plantar fascia. Therefore, it can be said that plantar fasciitis is often a psychosomatic disease. So far, the author has seen many cases of anxiety disorders or depression patients with comorbid plantar fasciitis at the same time in clinical practice, but most of these patients have not seen kidney deficiency that can be used to nourish the kidney.

Mind-body tension can induce tightness, spasm and pain in the plantar fascia. The author believes that the pathogenesis mainly lies in the mind-body related "no softness will cause spasm" and "no softness will cause pain". The original Chinese classic " Huangdi Neijing " discusses: "The bones are straight and the tendons are soft, and the qi and blood flow." Soft means soft and soft; "not soft" refers to spasms and emergency states of soft tissues such as whole body or local muscles, fascia , ligaments, etc. caused by mental and physical tension. Based on the mental and physical tension state of "not soft will cause spasm", it is no surprise that "not soft will cause pain".

Planet fasciitis is mainly manifested as pain in the acrofoot, which is easily induced by continuous anxiety and a low temperature environment. In terms of treatment, compared with the internal medication, the single-acupuncture or warm moxibustion therapy of local acupuncture with "pain as acupoint" has a direct and convenient antispasmodic and analgesic effects. Often several treatments can significantly improve the symptoms of heel pain. The author learns this acupuncture treatment experience from Japanese acupuncture doctors.

Planet fasciitis pain can occur anywhere in the plantar fascia, but it is most common in the base of the calcaneal foot. The picture comes from the Internet.