How to treat insomnia caused by deficiency of both heart and spleen?

Deficiency of both the heart and spleen often occurs in the elderly and frail, or in people who have been depressed for a long time, or have just recovered from a serious illness. It often leads to symptoms of qi, blood and yin deficiency, often causing frequent dreams and easy awakening, and symptoms such as dizziness. At this time, you can take some Chinese medicine to carry out syndrome differentiation and treatment. You can choose appropriate additions and subtractions of medicinal materials in the prescription according to the severity of the disease, and you should also pay attention to conditioning in daily life.

(1) Symptoms: Patients have difficulty falling asleep, or have many dreams during sleep, wake up easily, and have difficulty falling asleep again after waking up, or have palpitations, panic, fatigue, weakness, bland taste in the mouth, or abdominal distension after eating, loss of appetite, sallow complexion, pale tongue, thin white tongue coating, and slow and weak pulse. This type of insomnia is more common in clinical practice.

(2) Pathogenesis: Due to deficiency of both heart and spleen, blood is insufficient, which cannot nourish the mind, causing restlessness, insomnia, frequent dreams, and difficulty falling asleep after waking up; blood deficiency cannot nourish the face, so the complexion is dull and sallow; palpitations, drowsiness, fatigue, and weakness are all signs of insufficient qi and blood; if the spleen is deficient, food will be tasteless; if the spleen is not functioning well, the abdomen will be bloated after eating; if the stomach qi is weak, there will be no appetite or the appetite will decrease.

(3) Treatment method: Nourish the heart and spleen, nourish blood and calm the mind.

(4) Prescription: Guipi Decoction.

(5) Medication: Codonopsis pilosula 30g, Astragalus membranaceus 18g, Angelica sinensis 12g, Longan pulp 12g, Atractylodes macrocephala 9g, Costusroot 6g, Tangerine peel 6g, Poria 15g, Ziziphus jujuba seed 18g, Polygala tenuifolia 15g.

(6) Explanation of the prescription: Codonopsis pilosula and Astragalus membranaceus in the prescription replenish the Qi of the heart and spleen, while Angelica sinensis and longan pulp nourish the blood of the heart and spleen. Atractylodes macrocephala, costus root and dried tangerine peel strengthen the spleen and promote the flow of qi. Poria, jujube seed and polygala tenuifolia nourish the heart and calm the mind. Together they have the effects of nourishing the heart and spleen, nourishing blood and calming the mind.

(7) Add or subtract: For patients with insufficient heart blood, add 10g white peony root, 12g cooked rehmannia root and donkey-hide gelatin beads to nourish the heart blood; for patients with severe insomnia, add 12g Schisandra chinensis and 15g cypress seed to help nourish the heart and calm the mind, or add 12g Albizzia julibrissin bark, 30g each of Polygonum multiflorum, Dragon bone and Oyster to calm the mind; for patients with abdominal distension, poor appetite and greasy tongue coating, add 10g each of Pinellia ternata and Magnolia officinalis, 12g dried tangerine peel and 15g Poria to strengthen the spleen, regulate qi and resolve phlegm. Those with spleen deficiency and loose stools should warm the spleen and calm the mind.