基于藏象理论探讨儿童发声性抽动从肺论治“金鸣五应”中医机理  

Discussion on the Chinese medicine‘the lung controls the voice’mechanism in the treatment of vocal tic in children from lung based on the theory of Zangxiang

作　　者：周荣易 马丙祥[1,2] 韩新民[3] 张永婷 谢新月 吴晨蕾 ZHOU Rong-yi;MA Bing-xiang;HAN Xin-min;ZHANG Yong-ting;XIE Xin-yue;WU Chen-lei(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450000,China;Nanjing University of Chinese Medicine,Nanjing 210023,China;Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院,郑州450000 [2]河南中医药大学儿科医学院,郑州450000 [3]南京中医药大学,南京210023 [4]河南中医药大学,郑州450000

出　　处：《中华中医药杂志》2023年第3期988-992,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(No.82104928);中国博士后科学基金第70批面上项目(No.2021M701123);河南中医药大学第一附属医院博士科研启动项目(No.CZ0168-04);河南省卫健委中医研究基地专项(No.2019JDZX2022,No.2022JDZX085)。

摘　　要：抽动障碍为儿科较常见神经精神系统疾病,其中以发声性抽动临床治疗更具有挑战性。在中医理论中“金者肺,肺主声”,肺为娇脏,以华盖居高位,与外气相通,具有主气司呼吸、朝百脉主治节及主行水的生理功能,而小儿“肺常不足”,发声性抽动病位主要在肺系咽喉。从藏象理论肺之功能出发,发声性抽动的病因病机主要表现为金鸣五应,即外邪侵袭,金叩则鸣;肺为贮痰之器,金实则鸣;宣降失职,气机逆乱,冲逆则鸣;肺气不足,助血行无力,金虚则鸣;行水无权,气门失润,金鸣不破。从肺论治发声性抽动,旨在强调肺脏在发声中的重要作用,建立以肺为主,兼顾五脏的发声性抽动辨治体系,指导临床辨证论治。Tic disorder is a common neuropsychiatric disease in pediatrics.The clinical treatment of vocal tics with abnormal vocalization is more challenging.In the theory of traditional Chinese medicine,‘king is lung,lung mains voice’,lung is vulnerable to disease,the highest position in the five zang viscera,connected with the external air,with the main qi division of breathing,auxiliary blood operation and the main physiological function of water,children‘lung is often insufficient’,vocal tic disease location is mainly in the throat and other respiratory tract.Based on the lung function of zangxiang theory,the etiology and pathogenesis of vocal tics are mainly manifested as five types.External pathogenic factors attack the lungs like a bell being rung;Lung for the storage of sputum,sputum full of lung,air impact will give out abnormal sound;Lung main respiratory function is abnormal,the rise and fall of qi dysfunction is abnormal sound;Lung qi deficiency,auxiliary blood operation weakness,viscera nutrition loss is issued abnormal sound;The lungs are abnormal in assisting the operation of human water,and the larynx and other vocal organs are abnormal in vocalization due to the loss of body fluid moisture.Treating vocal tics from the lungs aims to emphasize the important role of the lungs in vocalization,establish a system of differentiation and treatment of vocal tics with the lung as the main body and consider the five zang viscera,to guide clinical diagnosis and treatment of symptoms and signs.

关 键 词：抽动障碍 发声性抽动 肺主发声 金鸣五应 从肺论治 

分 类 号：R277.7[医药卫生—中医学]