基于圆运动及五神藏理论从肺论治注意缺陷多动障碍  

Treating Attention Deficit Hyperactivity Disorder from the Lung Based on Circular Movement and Five Spirits Stored in Corresponding Viscera Theory

作　　者：叶志华 张来英 张端秀 王俊宏[2,3] YE Zhihua;ZHANG Laiying;ZHANG Duanxiu;WANG Junhong(Xiamen Hospital,Dongzhimen Hospital,Beijing University of Chinese Medicine/Xiamen Hospital of TCM,Xiamen,361009;Institute of Pediatrics,Beijing University of Chinese Medicine(Xiamen);Dongzhimen Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院厦门医院/厦门市中医院,福建省厦门市361009 [2]北京中医药大学儿科研究所(厦门) [3]北京中医药大学东直门医院

出　　处：《中医杂志》2024年第4期428-433,共6页Journal of Traditional Chinese Medicine

基　　金：北京中医药大学中央高校基本科研业务费专项(揭榜挂帅项目)(2023-JYB-JBZD-011);北京中医药大学教学名师工作坊(MSF1818);北京中医药大学儿科研究所建设项目(京中校发[2022]113号)。

摘　　要：认为主导知觉、行为及感觉功能的魂魄失常为注意缺陷多动障碍的主要病机,即肝魂左升太过、肺魄右降不及,其中又以肺魄不宁、肺失敛降为核心。从圆运动及五神藏理论角度分别对基于“心-肺-肾-肝四维不运”之注意缺陷、基于“肝-心-肺将相失和”之多动、冲动进行病机分析,认为肺魄在本病发病中具有重要作用,进而归纳为“五脏相关、以肺为枢”的发病特点以及“肺魄不宁、肺失敛降”的核心病机。提出虚证以自拟静宁方加减治疗,可补肺宁魄、以滋阴源;因虚致实者在静宁方的基础上加用清肺、平肝、化痰之品,以清金定魄、抑木安魂、化痰祛瘀,旨在建立“五脏证治、突出调肺”的辨治体系,以期为临床诊治提供理论参考。It is believed that the main pathogenesis of attention deficit hyperactivity disorder(ADHD)is the abnormality of the ethereal and corporeal soul that dominate perception,behaviour and sensory functions,that is,the left liver ethereal soul ascending too much while the right lung corporeal soul failing to descend,of which lung corporeal soul restlessness and lung failing to astringe and descend is the core.By analyzing the pathogenesis of attention defects due to“heart-lung-kidney-liver four dimensions circuit failure”and hyperactivity and impulsivity due to“liver-heart-lung chief and deputy disharmony”from the perspective of circular movement and five spirits stored in corre⁃sponding viscera theory,respectively,it is believed that the lung corporeal soul plays an important role in the onset of this disease,and further summarized that“the five zang(脏)organs are correlated,and the lungs are the pivot”is the pathogenic characteristics,and“the lung corporeal soul is restless,and the lungs fail to astringe and descend”is the core pathogenesis.It is proposed that deficiencies can be treated with self-made Jingning Formula(静宁方)modifica⁃tion to supplement the lungs,calm the corporeal soul,and nourish the source of yin.For deficiency leading to excess,medicinals of clearing the lung,calming the liver,and dissolving phlegm in addition to Jingning Formula can be used to clear metal and calm corporeal soul,inhibit wood and calm ethereal soul,dissolve phlegm and dispel stasis,so as to establish a differentiation and treatment system of“treating syndromes of the five zang organs and focusing on regulating the lungs”,and then provide theoretical reference for clinical diagnosis and treatment.

关 键 词：注意缺陷多动障碍 圆运动 五神藏 肺魄不宁 肺失敛降 

分 类 号：R277.7[医药卫生—中医学]