1.北京中医药大学,北京市朝阳区北三环东路11号,100029
2.中国中医科学院广安门医院
3.北京中医药大学东直门医院
drjhwang@bucm.edu.cn
收稿:2023-03-20,
修回:2023-09-12,
纸质出版:2024-01-17
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翟睿,段娟,李园等.基于王旭高“治肝三十法”探析儿童抽动障碍的病机和辨治思路[J].中医杂志,2024,65(02):149-153.
ZHAI Rui,DUAN Juan,LI Yuan,et al.Pathogenesis and Differentiated Treatment Strategies of Childhood Tic Disorders Based on WANG Xugao's “Thirty Methods of Treating the Liver”[J].Journal of Traditional Chinese Medicine,2024,65(02):149-153.
翟睿,段娟,李园等.基于王旭高“治肝三十法”探析儿童抽动障碍的病机和辨治思路[J].中医杂志,2024,65(02):149-153. DOI: 10.13288/j.11-2166/r.2024.02.006.
ZHAI Rui,DUAN Juan,LI Yuan,et al.Pathogenesis and Differentiated Treatment Strategies of Childhood Tic Disorders Based on WANG Xugao's “Thirty Methods of Treating the Liver”[J].Journal of Traditional Chinese Medicine,2024,65(02):149-153. DOI: 10.13288/j.11-2166/r.2024.02.006.
基于王旭高“治肝三十法”,认为儿童抽动障碍的发生发展以肝气病→肝火病→肝风病的动态演变规律为主线,三个阶段分别以肝气郁结、肝火亢盛、肝风内动为基本病机;同时以肝血虚滞、肝阴失养为主的肝之气血阴阳偏颇为要点,以他脏累及或渐及他脏的五脏关系失衡为补充。以治肝三十法为指导原则,TD肝气病治以疏肝理气法、疏肝通络法,可用小柴胡汤、四逆散;TD肝火病治以清肝法、泻肝法、化肝法,可用龙胆泻肝汤、泻青丸、当归龙荟丸、化肝煎;TD肝风病治以熄风和阳法、熄风潜阳法,可用羚角钩藤汤、六味地黄丸;同时全程兼顾调和肝之本脏气血阴阳以及他脏病变的治疗。
Based on WANG Xugao's “thirty methods of treating the liver”, it is believed that the occurrence and development of childhood tic disorders follow the dynamic progression from liver
qi
disease to liver fire disease and then liver wind disease. The basic pathogenesis of three stages are characterized by binding constraint of liver
qi
, liver fire hyperactivity, and internal stirring of liver wind. Moreover, liver-blood deficiency and stagnation, and malnutrition of liver
yin
as the main point in terms of the imbalance of liver
qi
, blood,
yin
, and
yang
should be considered, as well as the imbalance relationship of the five
zang
organs such as the involvement of other organs and the gradually reach of the other organs. Guided by the principles of “thirty methods of treating the liver”, the treatment of tic disorders in liver
qi
stage should focus on soothing the liver and rectifying
qi
, soothing the liver and unblocking the collaterals, using
Xiaochaihu Decoction
(小柴胡汤) and
Sini Powder
(四逆散). The treatment of tic disorders in liver fire stage involves clearing, draining and resolving liver heat, using
Longdan Xiegan Decoction
(龙胆泻肝汤)
, Xieqing Pill
(泻青丸)
, Danggui Longhui Pill
(当归龙荟丸)
,
and
Huagan Decoction
(化肝煎)
.
The treatment of tic disorders in liver wind stage involves extinguishing wind and subduing
yang
, using
Lingjiao Gouteng Decoction
(羚角钩藤汤) and
Liuwei Dihuang Pill
(六味地黄丸). Throughout the treatment process, attention should be paid to harmonizing the liver's
qi
, blood,
yin
, and
yang
, as well as addressing the pathology of other organs.
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