基于动静观与阴火理论探讨儿童注意缺陷多动障碍的病机辨治

Pathogenesis and treatment of attention deficit hyperactivity disorder in children based on the view of movement and stillness and the theory of yin fire

注意缺陷多动障碍作为儿科常见的神经发育障碍性疾病之一,严重影响广大儿童身心健康与个人发展。中药在改善核心症状、减轻药物不良反应方面具有优势。中国古代动静观认为,疾病生于阴阳动静的失衡,阴火源于脾胃虚损后阳气升发与阴气静藏的动静状态失衡,是一种虚性火热邪气。凡动皆属火,此病理状态与注意缺陷多动障碍患儿神思涣散、行为躁动的表现多有相符之处。王俊宏教授认为,脾胃亏虚、元气不足为注意缺陷多动障碍的发病基础,阴火邸张、动静失衡为其病势动态,湿火闭塞、气机郁结为其病理因素,治疗上应以“除阴火、平动静”为总纲,健运脾胃以伏火、益气养阴以涵动、调和气机以通静,同时遵循儿童体质特点与动静药性配伍规律,附临床验案一则以供参考。

Attention deficit hyperactivity disorder(ADHD),as one of the common neurodevelopmental disorders in pediatrics,seriously affects the physical and mental health and personal development of children.Chinese medicines have advantages in improving its key symptoms and reducing adverse drug reactions.The ancient view of movement and stillness in China holds that diseases arise from the imbalance of movement and stillness between yin and yang.Yin fire originates from the imbalance between the rising of yang qi and the static storage of yin qi following the spleen and stomach deficiency,which is a deficiency type of fire-heat pathogenic factor.All movements belong to fire,and this pathological state is often consistent with the symptoms of inattention and restlessness in children with ADHD.Professor WANG Junhong believes that the spleen and stomach deficiency and insufficient yuan-primordial qi are the basis of ADHD.Yin fire stagnation and imbalance of movement and stillness are the conditions of the disease,while dampness-fire obstruction and qi stagnation are the pathological factors.Following the general principle of"removing yin fire and balancing movement and stillness",the treatment involves strengthening the spleen and stomach to clear fire,supplementing qi and nourishing yin to regulate movement,and harmonizing qi to ensure stillness.At the same time,it should follow the characteristics of children's constitution and the compatibility rules of Chinese medicines with properties of movement or stillness.A clinical verified medical record is attached for reference.