摘要
抽动障碍是一种神经发育障碍性疾病,依据其核心症状可归属于“肝风”“风证”“瘛疭”范畴,中医临证以风立论,病机认识以肝为核心。抽动障碍临床证候较为繁杂,基于“象-气化”理论,本文从内风妄动病理基础进一步探索肝风、肺风、心风、脾风、肾风,提出肝阳亢盛所致的肝风是抽动障碍内风妄动的核心病源,肺失宣肃所致的肺风是主要诱因,在五脏生克制化下肝与心、脾、肾相关,可进一步因心气不定派生心风、脾失健运派生脾风、肾水不足派生肾风,五风共同影响抽动障碍的发病、发展与转归。基于上述病机认识,临证辨识抽动障碍患儿具体证候特点,由象知气化之变,故五风辨治体系中平肝、宣肺之法贯穿始终以治内风妄动之根,可选小柴胡汤、桑菊饮、苍耳子散等加减,运用制心火、运脾土、补肾水之法分治派生之象,可选泻青丸、导赤散、异功散、二陈汤、六味地黄丸等方加减。
Tic disorder(TD)is a neurodevelopmental disorder.According to the core symptoms,it can be classified as"liver wind","wind syndrome",and"concurrent".The clinical syndrome of TCM is based on wind,and the pathogenesis is based on the liver.However,the clinical symptoms of this disease are relatively complicated.Based on the"manifestation-qi transformation"theory,this study further explores the liver wind,lung wind,heart wind,spleen wind,and kidney wind from the pathological basis of intrinsic wind rash movement and proposes that the liver wind caused by hyperactivity of liver yang is the main cause of intrinsic wind rash movement in TD,and the lung wind caused by lung loss is the main cause.The liver is related to the heart,spleen,and kidney.Together,the five-wind affect the onset,development,and outcome of TD.Based on this understanding of the pathogenesis,it is necessary to identify the specific syndromes of the patients.The five-wind differentiation and treatment system uses the method of calming the liver and dispelling the lungs to treat the root of the internal wind rash movement.Xiaochaihu Decoction,Sangju Decoction,Cang′erzi Powder,and other prescriptions can be used with modification and subtract and use method of controlling heart fire,transporting spleen soil,and nourishing kidney water to treat derived images.Meanwhile,Xieqing Pill,Daochi Powder,Yigong Powder,Erchen Decoction,Liuwei Dihuang Pill,and other prescriptions can be used with modification.
作者
刘文博
史文丽
马丙祥
田潇阳
李宇迪
温盈盈
LIU Wenbo;SHI Wenli;MA Bingxiang;TIAN Xiaoyang;LI Yudi;WEN Yingying(School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450099,China;Pediatric Hospital of the First Affiliated Hospital,Henan University of Chinese Medicine,Zhengzhou 450099,China)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2024年第8期1075-1080,共6页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家自然科学基金项目(No.81904252)
河南省科技厅科技发展计划项目(No.22102310454)
2023年度河南省中医学“双一流”创建科学研究专项(No.HSRP-DFCTCM-2023-8-28)
河南省中医药科学研究专项(No.2023ZY2057,No.2023ZY2036)。
关键词
风
象
五风
五脏
抽动障碍
wind
manifestation
five-wind
five viscera
tic disorder
