基于“五迟五硬”探讨益肾健脾调肝法治疗痉挛型脑瘫的思路

Discussion on the thought of invigorating kidney,strengthening spleen and regulating liver for treating spastic type of cerebral palsy based on‘five stiffness and five retardations’

痉挛型脑瘫是常见的儿童致残性疾病,若不及时治疗,肌腱和关节囊挛缩持续存在并加重,患者生长发育受限,肢体发生严重的固定畸形,生活自理能力和社会适应能力出现严重缺陷。文章简要回顾了古代中医文献对痉挛型脑瘫的论述,结合临床实际,提出以"五迟五硬"作为痉挛型脑瘫的中医病名,进一步分析了肾、脾、肝三脏在"五迟五硬"发病中的相互作用,总结痉挛型脑瘫的中医病机为肾脾亏虚,肝风内动,治疗当以益肾健脾调肝为基本法则。

Spastic type of cerebral palsy is a common disease in childhood with high incidence of disability.If it is not treated in time,the contracture of tendon and joint capsule will continue to exist and aggravate.The growth and development of the patient is limited,the limbs have serious fixed deformity.The patients will lose ability of self-caring and social adaptation in the end.Based on clinical practice,this paper briefly reviewed the discussion about spastic type of cerebral palsy in ancient TCM literatures,proposed’five stiffness and five retardations’as the TCM disease name of spastic cerebral palsy,and further analyzed the interaction of kidney,spleen and liver in the pathogenesis of’five stiffness and five retardations’,summarized the TCM pathogenesis of spastic type of cerebral palsy was the deficiency of kidney and spleen and the internal stirring of liver wind.Therefore,the basic principles of treating spastic type of cerebral palsy is’invigorating kidney,strengthening spleen and regulating liver’.