基于伏邪学说对儿童抽动障碍发病机制的研究

A pathogenesis study of tic disorder in children based on pathogen incubation theory

伏邪学说分"感而不发"和"伏而后发"两个阶段。临床发现部分抽动障碍患儿发病或复发与外感六淫邪气有较强的时间和病程相关性,与伏邪学说致病机制相似,故首次提出抽动障碍之"伏邪致动"理论。该理论认为外感邪气侵袭肌表,伏藏于半表半里而暂时不发怍,在外感邪气、情志变化等刺激下再次发病;病位在肺与肝,与风邪关系密切,系外风引动内风;治宜肝肺并调,一则宣肺肃降以疏散外风,二则疏肝通络以熄内风,表里同调,标本兼治。

Pathogen incubation theory includes ＂ no manifestation after infection＂ and ＂manifestation after incubation＂. Clinical data showed that the incidence and recurrence of tic disorders in children had a strong relevance to six exogenous factors. The pathogenesis is similar to the pathogenic mechanism based on incubation of pathogen theory, so we proposed a theory of ＂tic disorder induced by incubation of pathogen＂. Pathogenic wind can be classified into exterior wind and endogenous wind. Pathogenic wind is more apt to move, rise and migrate. The characteristics of pathogenic wind, especially easy mobility, determine the symptoms and signs of tic disorder, for pathogenic wind can be characterized by vibration and involuntary movement such as convulsion and tremor. If exogenous pathogenic wind moves into half-exterior and half-interior phase from the exterior, both the exterior and interior syndromes should be treated at the same time. We should regulate the function of the liver and the lung, expel pathogenic wind by dispersing the lung, and calm endogenous wind by removing obstruction in the collaterals and soothing the liver.