王晓鸣教授运用调和肝脾法治疗儿童抽动障碍经验探讨

Discussion on Professor WANG Xiaoming's Ecademic Experience in the Treatment of Children with Tic Disorder with the Method of Harmonizing Liver and Spleen

[目的]总结王晓鸣教授运用调和肝脾法治疗儿童抽动障碍的学术经验。[方法]通过学习王师治疗儿童抽动障碍的遣方用药思路,从理论溯源、理论依据、具体应用、病案举隅四方面分析王师调和肝脾治法的精髓。[结果]儿童抽动障碍的病机以“肝旺脾虚”为主,表现为肝阳上亢,肝风内动,脾胃不和,甚至脾胃虚弱,肌肉失养,故在治疗过程中,以调和肝脾为总体思路。王师强调,运用此法治疗抽动障碍,需灵活运用疏肝、柔肝、健脾、舒筋、消积化滞等方法调和肝脾,常选用天麻钩藤饮、二陈汤、柴胡疏肝散、四逆散等方剂进行治疗。文中医案,王师辨为肝旺脾虚证,治以调和肝脾,方拟调和止动汤,随证加减,疗效显著。[结论]王师临证治疗儿童抽动障碍以调和肝脾为切入点,根据患儿临床表现、证候群的不同,灵活遣方,改善患儿的抽动症状效果显著,值得学习与推广。

[Objective]To summarize Professor WANG Xiaoming's academic experience in the treatment of children with tic disorder with the method of harmonizing the liver and spleen.[Methods]The essence of Professor WANG's method of treating children with tic disorder was analyzed from four aspects:theoretical source,theoretical basis,specific application and case study.[Results]The pathogenesis of children's tic disorder is mainly“liver effulgence and spleen deficiency”,which is manifested as liver Yang hyperactivity,liver wind internal movement,spleen and stomach disharmony,even spleen and stomach weakness and muscle dystrophy.Therefore,in the treatment of this disease,the general idea is to harmonize the liver and spleen.Professor WANG stresses that the using this method to treat tic disorders,needs to flexibly sooth the liver,soften the liver,strengthen the spleen,relax the tendons,eliminate accumulation and stagnation,and other methods to adjust the liver and spleen,often choose Tianma Gouteng Drink,Erchen Decoction,Chaihu Shugan Powder,Sini Powder and other prescriptions for treatment.In the medical case of the article,Professor WANG distinguished the syndrome of liver effulgence and spleen deficiency,and treated it to harmonize the liver and spleen,the prescription was Tiaohe Zhidong Decoction,and the effect was remarkable.[Conclusion]Professor WANG's clinical treatment of children with tic disorder takes the coordination of liver and spleen as the starting point.According to the different clinical manifestations and syndrome groups of children,flexible prescription has a remarkable effect on relieving the tic symptoms of children,which is worth learning and promoting.