A Case Report of Korean Medicine Treatment for Hwa-byung with Chronic Headache, Dizziness, Insomnia, and Chest Discomfort: Focused on Changes in the Hwa-Byung Scale and Physiological Measures

Objectives: This study aimed to describe the clinical course of a patient with Hwa-byung treated with Korean medicine by assessing changes in subjective symptoms, the Hwa-Byung Scale, and physiological measures.Methods: A 61-year-old woman with headache, dizziness, insomnia, and chest discomfort received herbal medicine, acupuncture, electroacupuncture, pharmacopuncture, cupping, and moxibustion. Outcomes included Numeric Rating Scale (NRS) scores, the Hwa-Byung Scale, Fitbit Inspire 2 sleep records, and heart rate variability (HRV) measured before, immediately after, and 15 minutes after electroacupuncture on three occasions.Results: NRS scores decreased from 7 to 3 for headache/dizziness, 6 to 4 for sleep-related discomfort, and 6 to 3 for chest discomfort. The Hwa-Byung symptom score decreased from 40 to 26. Deep sleep generally increased until week 6. Resting HRV did not consistently improve, whereas post-stimulation and recovery responses changed over time.Conclusions: Symptoms improved, and repeated HRV and wearable sleep measurements showed exploratory changes that may complement subjective assessments.