从脑神与五脏神辨治小儿多发性抽动症共患病
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摘要
结合古代文献与临床经验,应用中医的五脏神与脑神理论对多发性抽动症共患病的病机、证候特点与临床辨证用药等进行系统探讨。认为多发性抽动症始发于脾,并发于肝,失调于脑,脑神被扰是其核心病机,随着病机不同演变,而呈现出一定的倾向性:心神失守,易共患焦虑;肾志不足,易共患自闭;脾意不宁,易共患抑郁;肝魂失镇,易共患强迫;肺魄失藏,易共患多动。临床治疗中,则相应采取安心神、益肾志、强脾意、抑肝魂、收肺魄的不同治疗方法。
In this paper, the theory of five viscera Shen and brain Shen in traditional Chinese medicine is used to systematically investigate the pathogenesis, syndrome characteristics, and clinical syndrome differentiation-based treatment of the comorbidity of Tourette syndrome based on ancient literature and clinical experience. The authors consider that Tourette syndrome originates in the spleen, is concurrent in the liver, and causes imbalance in the brain. The brain Shen being disturbed is the core pathogenesis, and the changes in pathogenesis cause some trends in the comorbidity: anxiety induced by lost heart Shen; autism spectrum disorder induced by insufficient of kidney Zhi; depression induced by unquiet spleen Yi; obsessive-compulsive disorder induced by unhinged liver Hun; hyperactivity disorder induced by failure to store lung Po. The therapies for treating these mental diseases include calming heart Shen, nourishing kidney Zhi, strengthening spleen Yi, tranquilizing liver Hun, and colleting lung Po.
In this paper, the theory of five viscera Shen and brain Shen in traditional Chinese medicine is used to systematically investigate the pathogenesis, syndrome characteristics, and clinical syndrome differentiation-based treatment of the comorbidity of Tourette syndrome based on ancient literature and clinical experience. The authors consider that Tourette syndrome originates in the spleen, is concurrent in the liver, and causes imbalance in the brain. The brain Shen being disturbed is the core pathogenesis, and the changes in pathogenesis cause some trends in the comorbidity: anxiety induced by lost heart Shen; autism spectrum disorder induced by insufficient of kidney Zhi; depression induced by unquiet spleen Yi; obsessive-compulsive disorder induced by unhinged liver Hun; hyperactivity disorder induced by failure to store lung Po. The therapies for treating these mental diseases include calming heart Shen, nourishing kidney Zhi, strengthening spleen Yi, tranquilizing liver Hun, and colleting lung Po.
引文
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[12]王国才,潘立民,杨海波.基于中医魂魄理论探讨抑郁障碍的发病机制[J].中医杂志,2018,59(1):85-87.
[13]杨敏春,黄建波,张光霁.论“肝藏魂”而“肺藏魄”[J].中华中医药杂志,2016,31(10):3908-3910.
[14]孟庆岩,张庆祥.肺藏魄相关问题探讨[J].山东中医药大学学报,2014,38(4):311-312.
[15]张晓钢,贾竑晓.贾竑晓应用强肺魄理论治疗精神疾病临床经验[J].中华中医药杂志,2016,31(8):3118-3121.
[16]张慧,柳红良,赵志付.古代情志致病理论在中医心身疾病诊治中的应用[J].中华中医药杂志,2015,30(3):652-654.
[17]陈明优.“五脏神”学说探析[J].中国中医药现代远程教育,2014,12(14):18-19,29.
[2]刘智胜.儿童抽动障碍诊断要点[J].中国实用儿科杂志,2012,27(7):481-484.
[3]LECKMAN J F,BLOCH M H,SUKHODOLSKY D G,et al.Phenomenology of Tics and Sensory Urges:The Self Under Siege[J].2013:3-25.
[4]GANOS C,MARTINO D.Tics and Tourette Syndrome[J].Neurologic Clinics,2015,33(1):115-136.
[5]邹小兵,邓红珠.儿童抽动障碍共患病[J].中国实用儿科杂志,2012(7):485-587.
[6]ROBERTSON M M,EAPEN V,SINGER H S,et al.Gilles de la.Nature Reviews Disease Primers[J].2017,3:16097.
[7]张雯,王素梅,卫利,等.从“肝常有余、脾常不足”理论辨治小儿多发性抽动症[J].中医杂志,2013,54(24):2098-2099,2113.
[8]张晓梅,刘天浩,卫娜,等.基于肠道微环境探讨“心主神明”的内涵与外延[J].中医杂志,2017,58(19):1629-1632.
[9]任继学.悬壶漫录:国医大师任继学医论医案集[M].北京:北京科学技术出版社,2014.
[10]章薇.试论心神、脑神、五脏神及其关系[J].湖南中医学院学报,2003,23(3):28-29,44.
[11]周亚兵,吴敏,虞坚尔.基于中医脑病理论探讨抽动障碍临床辨治[J].中国中医药信息杂志,2009,16(7):89-91.
[12]王国才,潘立民,杨海波.基于中医魂魄理论探讨抑郁障碍的发病机制[J].中医杂志,2018,59(1):85-87.
[13]杨敏春,黄建波,张光霁.论“肝藏魂”而“肺藏魄”[J].中华中医药杂志,2016,31(10):3908-3910.
[14]孟庆岩,张庆祥.肺藏魄相关问题探讨[J].山东中医药大学学报,2014,38(4):311-312.
[15]张晓钢,贾竑晓.贾竑晓应用强肺魄理论治疗精神疾病临床经验[J].中华中医药杂志,2016,31(8):3118-3121.
[16]张慧,柳红良,赵志付.古代情志致病理论在中医心身疾病诊治中的应用[J].中华中医药杂志,2015,30(3):652-654.
[17]陈明优.“五脏神”学说探析[J].中国中医药现代远程教育,2014,12(14):18-19,29.