Table 8.
The syndrome differentiation of the three physicians for one patient in the treatment period.
| Physician A | Physician B | Physician C | ||
|---|---|---|---|---|
| The 1st treatment |
Chief complaint and history of present illness |
The primary symptoms associated with insomnia
(i) Insomnia for more than 20 years (ii) Sometimes difficulty initiating sleep (iii) Easy to wake up at night (iv) Not too much dream than before Other symptoms accompanied (i) Forgetfulness (ii) Dizziness (iii) Nausea and want to vomit (iv) Upper abdominal fullness (v) Impatience but controllable (vi) Good appetite (vii) Frequent stool (viii) Chronic atrophic gastritis (ix) Took Chinese medicine herbs before |
The primary symptoms associated with insomnia
(i) Insomnia for more than 20 years (ii) Difficulty initiating sleep (iii) Easy to wake up in 1-2 hours (iv) Not easy to sleep again after waking up Other symptoms accompanied (i) forgetfulness (ii) Sometimes dizziness (iii) A few months ago attacked with nausea and want to vomit (iv) Frequent stool, 3 or 4 times per day (v) To be bloated in head |
The primary symptoms associated with insomnia
(i) Insomnia for more than 20 years (ii) Go to bed at 22:00 every night (iii) Initiate sleep in 1-2 hours (iv) One or two days difficulty initiating sleep in a week (v) Not too much dream than before (vi) Wake up at 4:00 or 5:00 in the morning Other symptoms accompanied (i) To be bloated in top head (ii) Memory loss (iii) No palpitation (iv) No shortness of breath (v) The mood is ok. |
| Signs | (i) Dark complexion with chloasma (ii) Tongue: trembling, teeth-printed, a little deep of the tongue quality (iii) Pulse: stringy and thready pulse |
(i) Tongue: deep red tongue quality, teeth-printed, thin and yellow fur (ii) Pulse: stringy, thready, and slow pulse |
(i) Dark spots on the face, look dull, bulbar conjunctiva without congestive (ii) Tongue: pale of the tongue quality, thin and white fur (iii) Pulse: stringy and slow pulse |
|
| Syndrome pattern | Main pattern: blood deficiency | (i) Main pattern: blood not nourish heart (ii) Secondary pattern: blood stasis |
(i) Main pattern: stagnation of liver Qi and spleen deficiency (ii) Secondary pattern: blood stasis |
|
| Treating principle and prescription |
(i) Principle: nourishing blood for tranquillization (ii) Prescription: Gui Pi decoction |
(i) Principle: nourishing and promoting blood for tranquillization (ii) Prescription: TianWang Bu Xin Dan and Si Wu decoction |
(i) Principle: dispersing stagnated liver Qi for relieving Qi stagnation (ii) Prescription: Jie Yu San Jie decoction |
|
|
| ||||
| The 2nd treatment |
Chief complaint and history of present illness |
The primary symptoms associated with insomnia
(i) Sometimes the initiate sleep is improved (ii) Wake up per hour (iii) From midnight to 4:00 in the morning cannot sleep Other symptoms accompanied (i) Dizziness (ii) No nausea (iii) Upper abdominal fullness (iv) Dampness in the ears (v) Tongue ache for a whole night (vi) Scurrying pain of the body (vii) Stool irregular and shapeless (viii) Bitter taste in mouth and thirst (ix) Occasionally urticaria attacks |
The primary symptoms associated with insomnia
(i) The initiate sleep sometimes is rapid sometimes is slow (ii) Easy to wake up during the sleep Other symptoms accompanied (i) Dizziness (ii) Bitter taste and dry mouth (iii) Stool 2 times per day (iv) Head discomfort |
The primary symptoms associated with insomnia
(i) The quality of sleep is not so ideal (ii) Difficulty initiating sleep (iii) Not easy to sleep again after waking up in the night (iv) Too much dream (v) Get up in 5:00 in the morning Other symptoms accompanied (i) The urine and stool are normal (ii) Few sweating in the sleep (iii) Bitter taste and dry mouth (iv) There are rashes recently |
| Signs | (i) Tongue: the tip of tongue is red, yellow fur, teeth-printed (ii) Pulse: stringy and thready pulse |
(i) Tongue: red tongue quality, thin and yellow greasy fur (ii) Pulse: stringy and thread pulse |
(i) There are a few pigmentation, no rashes (ii) Tongue: red tongue quality, thin yellow fur and teeth-printed (iii) Pulse: deep and thready pulse |
|
| Syndrome pattern | Liver heat and phlegm blocking | (i) Main pattern: blood not nourishing heart (ii) Secondary pattern: phlegm-heat |
Main pattern: souls and spirits are uneasy | |
| Treating principle and prescription | (i) Principle: clear liver heat and remove phlegm (ii) Prescription: Huang Lian Wen Dan decoction |
(i) Principle: nourishing blood for tranquillization and removing phlegm-heat (ii) Prescription: regulation based on TianWang Bu Xin Dan and Wen Dan decoction |
(i) Principle: comfort the souls and brain for tranquillization (ii) Prescription: Zi Ni Fang (the formula prescribed according to the experience of physician C) |
|
|
| ||||
| The 3rd treatment |
Chief complaint and history of present illness |
The primary symptoms associated with insomnia
sleep for 2-3 hours Other symptoms accompanied (i) The tongue ache disappears (ii) Aphtha (iii) Scurrying pain of the body (iv) The urticaria attacks (v) Upper abdominal fullness is relieved (vi) Fear of cold (vii) Dizziness to close the eyes (viii) Bitter taste and dry mouth (ix) Thirsty (x) Stool irregular and shapeless is remission |
The primary symptoms associated with insomnia
(i) The initiate sleep is slow (ii) Often awake the whole night Other symptoms accompanied (i) Stomach bloating is remission (ii) Fear of cold |
The primary symptoms associated with insomnia
(i) Easy to wake up in the night (ii) Sometimes difficulty initiating sleep (iii) Too much dream Other symptoms accompanied (i) Sweating in the sleep (ii) Bitter taste and dry mouth (iii) Normal diet (iv) The stool and urine are normal (v) No chest tightness (vi) No shortness of breath (vii) Rash itching at night |
| Signs | (i) Yellow complexion, not shiny (ii) Tongue: deep red tongue quality, yellow fur (iv) Pulse: stringy and thready pulse |
(i) Tongue: red tongue quality, thin yellow greasy fur and teeth-printed on the edge (ii) Pulse: thready and stringy pulse |
(i) A few pigmentation on the face (ii) No rashes (iii) Sonorous voice (iv) Tongue: pale tongue quality, white fur (v) Pulse: deep and thready pulse |
|
| Syndrome pattern | Main pattern: liver heat and phlegm blocking | Main pattern: phlegm-heat disturbing heart mind | (i) Main pattern: syndrome of phlegm-heat attacking internally (ii) Secondary pattern: blood stasis |
|
| Treating principle and prescription | (i) Principle: clear liver heat and remove phlegm (ii) Prescription: regulation based on Huang Lian Wen Dan decoction |
(i) Principle: remove phlegm and clear heart heat (ii) Prescription: regulation based on Huang Lian Wen Dan decoction |
(i) Principle: clear heat for removing phlegm (ii) Prescription: regulation based on Shi Wei Wen Dan decoction |
|
|
| ||||
| The 4th treatment |
Chief complaint and history of present illness |
The primary symptoms associated with insomnia
(i) Initiate sleep for 1-2 hours (ii) Easy to wake up Other symptoms accompanied (i) The eyes are too dry to close (ii) The aphtha is healed (iii) The urticaria attacks in the night (iv) Legs and back ache (v) Upper abdominal fullness is relieved belching (vi) Fear of cold (vii) Dizziness to close the eyes (viii) Dizziness (ix) No bitter taste in the mouth but dry (x) Thirsty (xi) No falling feeling of the abdomen (xii) The stool is regular |
The primary symptoms associated with insomnia
(i) The initiate sleep is slow (ii) Easy to wake up Other symptoms accompanied (i) Stomach bloating is remission (ii) Occasionally belching (ii) Sometimes the urticaria attacks in night |
The primary symptoms associated with insomnia
(i) The initiate sleep is normal (ii) Easy to wake up in the night (iii) Not easy to sleep again after waking up (iv) Occasionally feel sleepy during the daytime Other symptoms accompanied (i) Not much night urine (ii) No sweating (iii) No upset (iv) No palpitations (v) Often sigh (vi) No headache (vii) No dizziness (viii) Menopause |
| Signs | (i) Tongue: red tongue quality of the tip, yellow fur and teeth-printed on the edge (ii) Pulse: stringy pulse |
(i) Tongue: red tongue quality, yellow greasy fur (ii) Pulse: thready and slow pulse |
(i) Tongue: red tongue quality, white fur (ii) Pulse: deep and slow pulse |
|
| Syndrome pattern | Main pattern: disharmony of Yin and Yang | Main pattern: phlegm-heat disturbing heart mind | Main pattern: syndrome of deficiency of heart yin | |
| Treating principle and prescription | (i) Principle: Harmony Yin and Yang (ii) Prescription: Gui Zhi add Long Gu and Mu Li decoction |
(i) Principle: remove phlegm and clear heart heat (ii) Prescription: regulation based on Huang Lian Wen Dan decoction |
(i) Principle: nourishing heart for tranquillization (ii) Prescription: regulation based on Jing Xin decoction |
|