1.河南中医药大学第一附属医院儿科医院,河南省郑州市金水区人民路19号,450000
2.河南中医药大学儿科医学院
dingying3236@sina.com
收稿:2025-02-27,
修回:2025-05-28,
纸质出版:2025-10-02
移动端阅览
李雪军,丁樱,张霞等.从“五脏藏神”角度探讨儿童遗尿症的辨治思路[J].中医杂志,2025,66(19):1995-1999.
LI Xuejun,DING Ying,ZHANG Xia,et al.Exploring Diagnostic and Therapeutic Approaches for Enuresis in Children Based on the Theory of the Five Zang Organs Storing the Spirit[J].Journal of Traditional Chinese Medicine,2025,66(19):1995-1999.
李雪军,丁樱,张霞等.从“五脏藏神”角度探讨儿童遗尿症的辨治思路[J].中医杂志,2025,66(19):1995-1999. DOI: 10.13288/j.11-2166/r.2025.19.006.
LI Xuejun,DING Ying,ZHANG Xia,et al.Exploring Diagnostic and Therapeutic Approaches for Enuresis in Children Based on the Theory of the Five Zang Organs Storing the Spirit[J].Journal of Traditional Chinese Medicine,2025,66(19):1995-1999. DOI: 10.13288/j.11-2166/r.2025.19.006.
基于《黄帝内经》中五脏藏神理论,认为五脏藏神功能失常是儿童遗尿症的关键病机,并提出以五脏调神为治则治法。心气不足、心神失藏、膀胱气化失常者治宜调心神,方用归脾汤加减;肺失宣降、肺魄不藏、水液妄行者治宜定肺魄,方用玉屏风散合菖蒲郁金丸加减;脾虚失运、脾意不藏、统摄水液无权者治宜养脾意,方用补中益气汤合菟丝子散加减;肝失疏泄、肝魂妄动、水渍横行者治宜安肝魂,方用龙胆泻肝汤佐入解郁安神之品;肾气亏虚、肾志不充、约束膀胱无力者治宜充肾志,方用自拟遗尿方加减。同时治疗全程配伍醒脑开窍之品以辅助调神。
Based on the theory of "five
zang
organs storing spirit" in
The Inner Canon of Yellow Emperor
(《黄帝内经》), it is believed that the dysfunction of the five
zang
organs in storing spirit is the key pathogenesis of enuresis in children, and thus the therapeutic principle and method of "regulating spirit through the five
zang
organs" are proposed. For patients with heart
qi
insufficiency, heart spirit failing to store, dysfunction of bladder
qi
transformation, the treatment should focus on regulating heart spirit, with modified
Guipi Decoction
(归脾汤) as the recommended prescription; for patients with lung failing to disperse or descend, corporeal soul of lungs failing to store, and unregulated flow of body fluids, the treatment should emphasize calming lung corporeal soul, using modified
Yupingfeng Powder
(玉屏风散) plus
Changpu Yujin Pill
(菖蒲郁金丸); for patients with spleen deficiency leading to dysfunction in transportation and transformation, failure of the spleen to store idea (one of the five spirits corresponding to the spleen), and inability to govern and regulate body fluids, the treatment should nourish spleen idea, adopting modified
Buzhong Yiqi Decoction
(补中益气汤) plus
Tusizi Powder
(菟丝子散); for patients with liver failure in dredging and dispersing, reckless stirring of liver soul (one of the five spirits corresponding to the liver), and abnormal accumulation and overflow of water-dampness, the tr
eatment should focus on calming liver soul, using
Longdan Xiegan Decoction
(龙胆泻肝汤) supplemented with herbs resolving depression and calming the spirit; for patients with kidney
qi
deficiency, insufficient kidney will (one of the five spirits corresponding to the kidney), and weakness in controlling the bladder, the treatment should replenish kidney will, using the modified self-prescribed
Yiniao Decoction
(遗尿方). Meanwhile, throughout the entire treatment process, herbs that awaken the mind and open the orifices are combined to assist in regulating the spirit.
王仲易 , 杜可 , 李晨 , 等 . 中医儿科临床诊疗指南:小儿遗尿症(修订) [J]. 中医儿科杂志 , 2018 , 14 ( 1 ): 4 - 8 .
AMIRI S , SHAFIEE-KANDIANI AR , NAGHINEZHAD R , et al . Comorbid psychiatric disorders in children and adolescents with nocturnal enuresis [J]. Urol J , 2017 , 14 ( 1 ): 2968 - 2972 .
王菁 , 吴忻晨 , 许丽金 , 等 . 小儿遗尿症的中医研究进展 [J]. 中国民族民间医药 , 2025 , 34 ( 9 ): 94 - 98 .
张博 , 任献青 , 傅文 , 等 . 基于“肾-髓-脑”轴和“阴跷脉”探析儿童遗尿症的病机及治疗思路 [J]. 中医杂志 , 2024 , 65 ( 9 ): 909 - 914 .
朱荣欣 , 丁樱 , 吴瑞红 , 等 . 从心肾相交理论出发探析小儿遗尿症的临床诊治 [J]. 天津中医药大学学报 , 2022 , 41 ( 5 ): 555 - 558 .
纪宇 , 颜红 , 沈莉 . “心主神明”的内涵与外延浅析 [J]. 中医杂志 , 2016 , 57 ( 10 ): 819 - 821,837 .
ZHANG Q , ZHU W , WANG C , et al . Nocturnal bladder function and sleep in the children with refractory nocturnal enuresis:a prospective study [J]. Urology , 2023 , 182 : 218 - 224 . doi: 10.1016/j.urology.2023.08.032 http://dx.doi.org/10.1016/j.urology.2023.08.032 .
王宪正 , 汪受传 . 从《黄帝内经》五脏藏神理论到《黄帝内经太素》五神脏理论的演变分析 [J]. 中医杂志 , 2020 , 61 ( 7 ): 569 - 572 .
王鹏 , 周欢 , 薛征 . 基于“肺肾同源”理论治疗小儿遗尿探析 [J]. 浙江中医杂志 , 2024 , 59 ( 6 ): 545 - 546 .
唐卷壹 . 川芎茶调散加减治疗儿童原发性遗尿症(肺郁脑闭证)的临床观察 [D]. 成都 : 成都中医药大学 , 2022 .
SHREERAM S , HE JP , KALAYDJIAN A , et al . Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S.children: results from a nationally representative study [J]. J Am Acad Child Adolesc Psychiatry , 2009 , 48 ( 1 ): 35 - 41 .
戴晓梅 , 麻宏伟 , 卢瑶 , 等 . 多巴胺D4受体基因多态性与原发性夜间遗尿症的关联研究 [J]. 中国当代儿科杂志 , 2008 , 10 ( 5 ): 607 - 610 .
王达洋 , 徐筱青 , 贺娟 . 论《黄帝内经》“五脏藏神”理论及其临床意义 [J]. 中医杂志 , 2017 , 58 ( 10 ): 892 - 894 .
周逸珊 , 廖先勇 , 饶克瑯 , 等 . 麻黄激发阳气的临床应用探讨 [J]. 广州中医药大学学报 , 2024 , 41 ( 1 ): 234 - 239 .
余光青 , 冷伟 . 浅谈麻黄在小儿遗尿症中的应用 [J]. 现代中医药 , 2018 , 38 ( 5 ): 109 - 111 .
马建辉 , 舒涛 , 刘晨曦 , 等 . “生物-心理-社会-工程”医学模式探讨 [J]. 医学与社会 , 2025 , 38 ( 5 ): 8 - 14 .
王倩 , 袁莉莉 , 张永玲 , 等 . 石菖蒲-郁金配伍治疗癫痫的网络药理学研究 [J]. 中国中药杂志 , 2019 , 44 ( 13 ): 2701 - 2708 .
0
浏览量
0
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号