這是一位42歲的男性病患，來診時主訴每日睡眠時右下肢陣發性抽搐抖動已2年多，多於每晚23~2點之間發生，發作時右小腿足背伸側連足踝與足趾陣發性痙孿強直，足背快速上下抖動，持續數秒鐘，暫停數秒鐘後再發。過程由太太以手機錄影記錄。望之精神疲憊，面色暗，目眶暗，問之平素有貧血、低血壓、耳嗚已多年。問之以往十多年來每日工作忙碌，經常超過十二小時，長期睡眠不足。白天工作時容易感覺疲倦，但手足肌力正常，沒有麻木感，肌肉無萎縮現象。右下肢陣務性抽搐抖動只會在半夜發作。診之脈沉，右關弱，左關尺弱。臨床診斷爲睡眠中週期性肢動症(PLMS)，中醫辨證爲肝腎陰虛，虛風內動。治則採養血滋陰，平肝熄風。處方用四物湯合杞菊地黃丸加減。服藥一週後右下肢抽搐抖動頻率與程度均明顯減輕，精神進步，耳嗚改善，鼻過敏現象改善。三週後抽搐抖并動頻率減爲每週二次，三個月後即未再發作。後續叮嚀病患宜正常進食，規律作息，以鞏固療效。

The 42years old male patient complained of concerning paroxysmal tics and jerks every night (usually between 11 pm and 2 am) for 2 years revealed: the paroxysmal tonic spasms over the dorsum of pedis, ankle and toes of the right leg, the dorsum of pedis jerking up and down quickly in seconds, and stopping in seconds before recurrence. The process was recorded by his wife on the cell phone. On the first visit, he had fatigue, the dark complexion; the dark rim around the eyes. According to him in the inquiry, his anemia, hypotension and tinnitus lasted many years; and frequently working over 12 hours everyday over 10 years caused his long term sleep deprivation. Likewise, he was weary at work by day. Nonetheless, the extremity strength was normal; no numbness; no atrophy. The paroxysmal tics and jerks in the right leg happened merely at midnight. The pulses were deep and weak (the right guan pulse was weak; so was the left chi pulse) The clinical diagnosis was Periodic Legs Movement of Sleep (PLMS).The Chinese syndrome differentiation was liver and kidney yin deficiency and endogenous wind were averred. The principal of treatment: the blood was tonified, yin nourished, besides the liver pacified and wind extinguished. The prescription, four substance decoction was modified with Three-Shell Decoction to Restore the Pulse added or reduced. One week after medication, the right leg tic and jerk frequency and intensity were saliently reduced; the vigor, tinnitus, and nose allergy were ameliorated. Three week after, the frequency decreased to 2 times per week; Three months after, the right leg tic and jerk disappeared. Additionally, the subject was reminded of a normal diet and a regular life to consolidate the curative effect