周晓卿辨治抽动秽语综合征经验撷英

Professor Zhou Xiaoqing's experience in differentiation and treatment of tourette syndrome

抽动秽语综合征(Tourette Syndrome,TS)病程长,易反复,对患儿及家长的身心造成明显影响。中医治疗本病有独特优势,疗效确切,标本兼顾,且不良反应小。周晓卿主任医师结合自身多年临床经验,运用中医整体观念、辨证论治思想治疗本病,认为本病根本在肝,或虚或实,涉及五脏。辨证分为:①肺胃郁热型。从调肺入手,肺卫受邪,夹风夹痰,易郁而化热,结合小儿脾弱之特点,治以清肺和胃、凉血息风,方选银翘散为基础方加减;②心肝火旺型。小儿体质为纯阳之体,辨本证多见为里实热证,治以宁心安神,凉肝息风为则,方选丹栀逍遥散为基础方加减;③脾肾亏虚型。运用“治病求本”思想,辨本证多为虚证,治以补脾益肾、养血息风,方选参苓白术散为基础方加减;④虚风内动型。从“整体观念”出发,治肝着手,兼顾他脏,调和阴阳,以滋阴潜阳、濡润息风为治则,方选益胃汤为基础方加减。常配伍平肝息风、重镇安神之品,遣方用药,随症加减,疗效满意。

Tourette syndrome has a long course and is easy to relapse,which has a significant impact on the physical and mental health of children and parents.Traditional Chinese medicine has unique advantages in treating this disease,its curative effect is exact,both the symptoms and the root causes are taken into account,and side effects are less.The chief physician Zhou Xiaoqing combines with his many years of clinical experience,applies the concept of holism and syndrome differentiation and treatment of traditional Chinese medicine to treat the disease.He believes that the disease is fundamentally in the liver,and involves the five internal organs.Differentiation is divided into:1.Stagnation heat of lung and stomach:Starting from regulating the lung,the lung-qi is affected by evil,the wind and phlegm are easy to stagnate,and the heat is produced.Combined with the characteristics of children's weak spleen,the treatment is based on clearing the lung and stomach,cooling blood and quenching wind.The prescription is based on Yinqiao powder(银翘散)for addition and subtraction.2.Hyperactivity of heart-liver fire:Children's constitution is pure yang,and the most common syndrome is interior excess heat syndrome.The treatment is based on calming the mind and soothing the spirit,cooling the liver and quenching the wind.The prescription is based on Danzhi Xiaoyao powder for addition and subtraction.3.Deficiency of spleen and kidney:Applying the idea of"treating the disease by seeking the root cause",and differentiating that the syndrome is mostly deficiency,and the treatment is nourishing the spleen and kidney,nourishing blood and quenching wind.The prescription is based on Shenling Baizhu powder(参苓白术散)for addition and subtraction.4.Internal motion of virtual wind:Starting from"the concept of holism"and treating the liver,taking other viscera into account,reconciling yin and yang,nourishing Yin and Yang(阴阳),and moisturizing and quenching wind is the principle.The prescription is based on Yiwei decoction(益胃汤)for addition and subtraction.It is often paired with Chinese herbal medicine such as Pinggan Xifeng and Zhongzhen Anshen,the prescription is added and subtracted,and the treatment effect is satisfactory.