基于心肝有余、肺脾肾不足及五神藏理论辨治儿童多发性抽动症

Syndrome Differentiation and Treatment of Tourette′s Syndrome in Children Based on Theory of Excess of Heart and Live, Deficiency of Lung, Spleen and Kidney and Five Organs of Mentality

多发性抽动症是好发于儿童时期的一种慢性神经精神障碍性疾病,反复发作、迁延多变,严重影响患儿的生活质量。中医学认为神志的正常离不开五脏的正常运行,亦离不开五神的调摄。故文章基于古代医家提出的“心肝有余,肺脾肾不足”及“五神藏”理论,结合丰富的临床实践,分析儿童多发性抽动症的病因病机、临床特点及遣方用药。该病之病位在五脏,“心肝有余、肺脾肾不足”及五神藏功能失常是本病发生发展的重要因素。从心论治,治以镇心养血安神,方选静心止动方加减;从肝论治,治以疏肝风清肝热,方选清肝达郁汤加减;从脾论治,治以健脾益气、涤痰开窍,方选涤痰汤加减;从肺论治,治以疏风清热、透邪解毒,方选银翘散加减;从肾论治,治以滋水涵木、柔肝息风,方选大定风珠加减。文章高度概括了儿童多发性抽动症的临床特点,对临床辨治本病提供新的思路。

Tourette's syndrome is a chronic neuropsychiatric disease that often occurs in children.It occurs repeatedly,delays and changes,and seriously affects the quality of life of children.Traditional Chinese medicine believes that the normal mind is inseparable from the normal operation of the five Zang organs and the adjustment of the five spirits.Therefore,based on the theories of“excess of heart and liver,deficiency of lung,spleen and kidney”and“five spirits storage”put forward by ancient doctors,combined with rich clinical practice,this paper analyzed the etiology,pathogenesis,clinical characteristics and prescription of children Tourette's syndrome.The disease is located in the five Zang organs.The idea of“excess of heart and liver,deficiency of lung,spleen and kidney”and dysfunction of five Zang organs storing spirits are important factors for the occurrence and development of the disease.The treatment from heart is calming the heart,nourishing blood and calming the mind method,and Jingxin Zhidong Formula(静心止动方)is used.The treatment of liver is to soothe liver wind and clear liver heat,and the prescription is Qinggan Dayu Decoction(清肝达郁汤).The theory of spleen is to strengthen spleen and replenish Qi,eliminate phlegm and open orifices,and the formula is Ditan Decoction(涤痰汤).The treatment of lung is to expel wind,clear heat,penetrate evil and detoxify,and the formula is Yinqiao Powder(银翘散).The treatment of kidney is nourishing water,containing wood,softening liver and calming wind,we can choose Dadingfengzhu(大定风珠).This paper highly summarized the clinical characteristics of children with Tourette's syndrome,and provided a new idea for the clinical differentiation and treatment of this disease.