睡眠差+乏力

患者年龄34岁，女性。主诉四肢关节冷痛7年余，加重2年，肩关节、上肢、膝关节发凉疼痛，项背部麻木蚁行感，头昏头痛伴眼痛6年，睡眠差，多梦，乏力，易生气，晨起干呕，大便质稍稀，月经后期12天。体征见胆明阳性，肩胛骨中部压痛。中医诊断痛痹。病因病机为寒气束表。舌象未提及，脉象未提及。

患者59岁，男性，主诉腰椎术后腰痛5天，发热伴乏力3天。腰痛，神疲，乏力，纳差，睡眠差，大便未排。舌红，少苔，脉弦细。中医诊断内伤发热，属气虚血瘀。

57岁，乏力、气短、纳差、肝区不适、两胁胀痛、睡眠差、大便软，病程30余年。肝郁脾虚，气虚血瘀。面色晦暗无光泽，舌淡红，苔薄白，脉平缓。蜘蛛痣，血清谷草转氨酶升高，血红蛋白降低，血小板减少。

女，45岁，腰酸痛，睡眠差，乏力，病程长。多囊肾病，肾虚湿滞血瘀证。面色晦暗，舌质暗红，舌苔薄白，脉沉细。耳鸣，腰膝酸软，夜尿多，尿浊。血肌酐270μmol/L，血尿酸460μmol/L。

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患者年龄35岁，女性。主诉胸闷痛，持续半月余。中医病名肋软骨炎，证型劳伤肺气，胸阳不展，气血瘀滞。舌象暗澹有齿痕，苔白，脉沉细。胸中闷痛，烦急，乏力不欲动，手足心汗出，睡眠较差，纳食尚可，二便调畅，月经尚调。

患者年龄66岁，女性。主诉头晕、视物旋转1年余，加重1周。主要症状包括头晕、视物旋转、脑鸣、耳鸣、便干、口干苦、五心烦热、盗汗、乏力、睡眠差。舌象暗红、苔薄，脉象弦长。血压150/85mmHg。影像学诊断为双侧基底节区、半卵圆中心、双侧顶叶内多发小缺血梗死灶；脑白质疏松症。二诊舌象红，脉象数，舌苔黄干。中医病名属眩晕，证型为肝阳上亢，病因病机为肝阳上亢、痰湿内阻。

男，36岁。夜间多汗，胸闷痛、心悸、乏力，汗出发作，严重时晕厥，睡眠差。舌红，苔白，脉细滑。气阴不足，营卫失调。

女，45岁，右胁牵及右肩胛下轻微胀痛不适，持续半年余。右胁轻微胀痛，伴乏力，睡眠稍差，大便干结。舌质澹红，苔薄白腻。脉弦数。肝郁气滞，痰瘀互结。

患者38岁，男性。主诉大便次数增多，日3～5次，呈糊状，偶有稀水样便，夹少量黏液，伴腹部胀满、下坠、疼痛，便后缓解。病情反复，因情志不畅及饮食生冷油腻加重。食欲不佳，精神差，易乏力，睡眠欠佳。舌暗红，苔白微腻，脉弦微滑。中医诊断肝郁脾虚。

53岁女性，口干渴多饮，多尿，饥饿多食，胸闷，心前区隐痛，睡眠差，乏力，四肢麻木感。舌质胖暗，苔薄白，脉沉弦。辨证为气阴两虚，经脉阻滞。病程糖尿病1年，高血压17年。

患者34岁，男性，主诉血精2月余。精囊炎，辨证为阴虚火旺证。舌质偏红，苔薄黄，脉细。舌象淡红薄白苔，脉象沉细。病程2月余。阴虚火旺，湿热毒邪下注。

女，39岁，乏力6个月。倦怠乏力，气少懒言，睡眠差，纳差。舌澹苔薄白，脉缓。紫癜病，气虚。病程6个月。

男，49岁，腹胀、乏力1a余，烦躁易怒，胸中时堵，饮食纳差，睡眠差，面黄，小便色黄，大便干燥，苔黄腻，脉弦、右小于左。中医病名未明确，证型为气血不足，肝郁痰凝，脾虚气滞。望诊见面黄，舌苔黄腻。闻诊未提。问诊见烦躁易怒、胸中不适、饮食纳差、睡眠差。切诊见脉弦，右小于左。

64岁男性，劳累后左侧胸前区疼痛、憋闷，活动后气短，精神不佳，睡眠差，周身乏力，纳差，素腹胀，大便偏干。胸痹，心脾气虚，痰瘀互阻。舌暗，苔白，脉细弦。

女，35岁，口干、眼干、腮肿、偶关节疼痛、胸闷、心慌、睡眠差。双唇肿胀，腮腺肿大，关节稍肿，屈伸受限。舌质红，少苔，脉细数。中医病名未明确，证型未明确，病因病机未明确。

男，77岁，蛋白尿、血尿，乏力，排泡沫样尿，睡眠差。慢性肾炎，脾肾气虚，精微下注。舌淡，苔白，脉细弦。

患者男性，60岁。主诉陈旧性心肌梗塞2年，烦躁，易出汗，睡眠差，活动后疲劳。舌暗苔白，脉弦细。中医诊断气虚血瘀，心肾不交。病机为气虚血瘀，心气不足，心肾不交。舌象为舌暗苔白，脉象为弦细。

65岁男性，间断口干渴12年，伴双下肢肿1年。口干渴、乏力、多汗、双下肢浮肿、腰部酸痛、眠差、小便频。舌红少苔，脉弦滑。中医诊断消渴肾病，证属肝肾阴虚、痰瘀阻络。病程长，有糖尿病及高血压病史。

男，22岁。口腔溃疡反复发作3年，与情绪异常有关。急躁，口臭，汗出黏腻，手背发烫，头晕，乏力，睡眠差，语迟发音不清，食欲不振，大便不爽。舌质暗红，苔白腻。脉弦细。肝郁化火，肝郁克脾，肝热脾湿，循经上扰于口。