时毓民教授治疗小儿多发性抽动症经验举隅

Professor SHI Yumin’s Experience in Treating Tourette Syndrome in Children

时毓民教授认为小儿多发性抽动症病机为脏腑功能失调,阴阳失衡所致,属本虚标实之证,根据本病病程迁延、反复发作的特点,临床分发作期和缓解期,应分期辨治。发作期以风火痰扰为患,为标实之证,涉及心、肝、脾、肺,其中以肝为主;缓解期以气血不足为主,为本虚之证,涉及心、肝、肾,其中以肝肾阴虚为要。治疗重视标本兼顾、分期施治,发作期治疗重在平肝风,清肝火,化痰浊,开清窍,辅以养肝血,通经络;缓解期治疗重在补气血,养肝肾,定神志,辅以活血化瘀。

Professor SHI Yumin believed that the pathology of Tourette syndrome in children is the dysfunction of viscera and the imbalance of Yin and Yang,leading to the deficiency of the root and excess of superficiality.According to the prolonged course of the disease and the characteristic of relapse,the disease can be divided into attack stage and remission stage,which should be treated respectively.The attack stage is disturbed with wind,fire and phlegm,which is the syndrome of excessive superficiality.This stage involves the attack of heart,liver,spleen and lung,mainly attacks the liver.The remission stage is the insufficiency of Qi and blood,which refers to the syndrome of deficiency of root.This stage involves heart,liver and kidney,mainly is liver-kidney Yin deficiency.The treatment should consider both the symptoms and the root,and treating according to the stage respectively.The treatment of attack stage is to calm the liver wind,clear the liver fire,resolve the phlegm,open and clear the orifices,assisted with the support of nourishing liver blood and dredging the meridian.The treatment of remission stage should focus on the supplement of Qi and blood,nourishing liver and kidney and calming the mind,assisted with promoting blood circulation to remove blood stasis.