李宜瑞辨治注意缺陷多动障碍经验

Experience of LI Yi-Rui in Differentiating and Treating Attention Deficit and Hyperactivity Disorder

注意缺陷多动障碍是儿童时期常见的以注意力不集中、多动和冲动为特征的精神-心理-行为障碍疾病之一。李宜瑞教授认为,本病系脏腑阴阳失调所致,心脾肾不足乃病机之本,常兼肝亢、痰湿等标证。临证时宜审慎辨证,用药以四君子汤为基础方,重视健脾,合用龙骨、首乌藤、白芍、石菖蒲、远志、益智、合欢皮、连翘等以增智养神、祛痰开窍,心脾肾同治;同时根据伴随症状进行加减用药,标本兼顾,以调和脏腑阴阳,从而改善注意缺陷多动障碍患儿的注意力、记忆力。

Attention deficit and hyperactivity disorder(ADHD)is one of the common mental-psychologicalbehavioral disorders in childhood characterized by inattention,hyperactivity,and impulsivity.Professor LI Yi-Rui believes that ADHD results from the disharmony of the zang-fu organ function and yin-yang,with the insufficiency of heart,spleen and kidney as the root of pathogenesis,and usually accompanied by the secondary symptoms of liver hyperactivity and phlegm-dampness.During the clinical practice,Professor LI Yi-Rui makes the differentiation of syndromes carefully,emphasizes the importance of therapy of fortifying spleen to replenish wisdom and nourish spirit,removing phlegm and inducing resuscitation,and treats the heart,spleen and kidney simultaneously by adopting Sijunzi Decoction as the fundamental recipe and by together using Draconis Os,Polygoni Multiflori Caulis,Paeoniae Radix Alba,Acori Tatarinowii Rhizoma,Polygalae Radix,Alpiniae Oxyphyllae Fructus,Albiziae Cortex,and Forsythiae Fructus.Moreover,modified medication is performed according to the accompanying symptoms,so as to harmonize the zang-fu organ function and yin-yang,and achieve good curative effect on improving the attention and memory of the children with ADHD.