杨文明教授治疗儿童多发性抽动症经验

Professor YANG Wenming's Experience in Treating Tourette Syndrome of Children

[目的]总结杨文明教授治疗儿童多发性抽动症的临床经验。[方法]通过临床侍诊、聆听讲解,分析总结相关临床病案,从儿童多发性抽动症的病因病机、治法方药等方面分析杨文明教授对多发性抽动症发病机制的认识和从肝肾论治的学术观点,探讨杨教授治疗本病的经验,归纳用药特点,并通过典型病案加以佐证。[结果]杨师认为肾虚肝旺、虚风内动是导致儿童多发性抽动症的主要病机,临证时应以滋肾柔肝、平衡阴阳为主,同时根据兼有的脾失健运、肺失宣肃、心神失养等不同病机特点选用相应药物,并注意护助脾胃;还可按病程特点选择合适药物剂型,配合适当的心理调适,以达到满意的治疗效果。所举验案患儿先天不足,肺肾虚损,复加外感风寒,故先以疏风宣肺、固表止痉治其标,再以滋养肺肾、息风安神固其本,方选荆防败毒散和六味地黄丸加减,获得良好疗效。[结论]杨文明教授从肾虚肝旺论治儿童多发性抽动症,临床疗效肯定,值得学习借鉴。

[Objective]To summarize the clinical experience of Professor YANG Wenming in treating Tourette syndrome of children.[Methods]Through clinical follow-up,listening to lectures,analyzing and summarizing the relevant clinical records,Professor YANG's understanding of the pathogenesis of Tourette syndrome and his academic views on treatment from the liver and kidney were analyzed,his experience in treating Tourette syndrome of children from the aspects of etiology,pathogenesis,therapeutic methods and prescriptions was discussed,and the characteristics of medication were summarized,and a typical case was presented as proof.[Results]According to Professor YANG,it is believed that the basic pathogenesis of Tourette syndrome of children lies in kidney deficiency and liver hyperactivity.In clinical practice,kidney nourishing,liver softening and Yin and Yang balancing should be the main methods.At the same time,appropriate drugs should be selected according to the different pathogenesis characteristics of children with spleen dysfunction,lung dysfunction,and mind dysfunction,and attention should be paid to protect and assist the spleen and stomach.According to the characteristics of the disease course,appropriate drug dosage forms should be selected,and appropriate psychological adjustment should be coordinated to obtain satisfactory therapeutic effects.The patient in the case was congenitally deficient,who had suffered from lung and kidney deficiencies,as well as exogenous wind and cold.Here firstly alleviated the symptoms with a wind dispelling,lung diffusing,exterior strengthening and spasm stopping prescription.Then the vital essence was reinforced with the lung and kidney nourishing,wind calming and mind tranquilizing pills.Results showed that modified Jingfang Baidu powder and Liuwei Dihuang Pills have promising clinical efficacy.[Conclusion]Professor YANG Wenming treats Tourette syndrome of children from kidney deficiency and liver hyperactivity,and obtains remarkable therapeutic effect,and it is worth learning.