运用角药治疗儿童抽动障碍临床思路探讨  

Clinical thoughts for the treatment of tic disorders in children with triangular herbs

作　　者：张蔷 孙婷[1] 张宁[1] 于敬龙[1] 闫雨柔 吕题颖 王俊宏[1] ZHANG Qiang;SUN Ting;ZHANG Ning;YU Jinglong;YAN Yurou;LYU Tiying;WANG Junhong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Bejing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《现代中医临床》2022年第4期50-54,共5页Modern Chinese Clinical Medicine

基　　金：北京中医药大学教学名师工作坊建设项目(No.MSGZF-201818);中央高校基本科研业务费专项资金资助项目(No.2020-JYB-XJSJJ-040)。

摘　　要：抽动障碍是一种临床以不自主、反复、突发、快速的,重复、无节律性的1个或多个部位运动抽动和/或发声抽动为主要特征的神经精神障碍性疾病,多见于儿童。儿童抽动障碍在中医学归属于“肝风”等范畴,病位在肝,与脾关系密切,肝风内动为基本病机,风痰阻络是其难愈之因,木郁土壅是其病进之因。角药是利用中药性味归经的特点,将3味中药合理配伍、联合使用的药物组合模式,在儿童抽动障碍的治疗中应用广泛。治疗儿童抽动障碍时,根据肝风内动、风痰阻络、木郁土壅的病机分别立调肝息风以止抽动、息风豁痰以通经络、运脾疏肝以调气机的治法,依法配伍中药形成固定角药。治疗时把握整体病因病机,辨病辨证相结合,灵活运用角药组方。结合验案对角药在儿童抽动障碍中的临床应用进行介绍。The tic disorders are neuropsychiatric disorders characterised by involuntary,repetitive,sudden,rapid,recurrent and nonrhythmic motor tics and/or phonic tics in one or more parts of the body,and they often occur in children.In traditional Chinese medicine,the tic disorders in children are classified as liver wind,located in the liver and closely related to the spleen.The basic pathogenesis is the liver wind stirring,the wind phlegm obstructing collaterals is the reason why this disease is difficult to cure,and the liver depression and spleen obstruction are the resason for its progression.Triangular herbs are a combination of three herbs,which are formulated according to the property,flavor,and meridian of the herb.Triangular herbs are widely used in the treatment of the tic disorders in children.According to the pathogenesis,three methods are formulated in treating children with the tic disorders,namely,regulating the liver and calming wind to stop tics,calming wind and expelling phlegm to dredge meridians and transporting the spleen and soothing the liver to regulate Qi.Therefore the fixed triangular herbs are formed accordingly.In terms of treatment,triangular herbs are used flexibly to form a traditional Chinese medicine prescription based on the holistic dialectics and the combination of disease differentiation and syndrome differentiation.Combined with clinical case,this paper introduces the clinical application of triangular herbs in children with the tic disorders.

关 键 词：抽动障碍 儿童 角药 肝风 

分 类 号：R272[医药卫生—中医儿科学]