基于“以证统病”探讨抽动障碍及其共患病的辨治思路  

Discussion on syndrome differentiation and treatment of tic disorder and its comorbidities based on syndrome differentiation

作　　者：张雯 赵艾婧 余斯雅 崔霞 王素梅 ZHANG Wen;ZHAO Aijing;YU Siya;CUI Xia;WANG Sumei(The Third Affiliated Hospital of Beijing University of Chinese Medcine,Beijing 100029;DongFang Hospital of Beijing University of Chinese Medcine)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学东方医院

出　　处：《现代中医临床》2024年第5期1-4,26,共5页Modern Chinese Clinical Medicine

基　　金：北京中医药薪火传承“3+3”工程王素梅名医传承工作站(No.2022-SZ-C-89);王素梅全国名老中医药专家传承工作室;第六批北京市级中医药专家学术经验继承项目(No.京中医科字[2021]169号)。

摘　　要：抽动障碍(tic disorder,TD)是一种起病于儿童时期,以抽动症状为主要表现的神经发育性疾病。其临床表现多样,可伴多种共患病,共患病增加疾病的复杂性和严重性。在中医整体思想的指导下,以证统病,异病同治,强调脾虚肝旺的核心病机,在整体辨证的基础上要兼顾共病的特殊性。脾虚肝旺常累及至肺,兼有气滞改变,临床易现抽动共患多动;脾虚肝旺累及至心,兼有火邪内扰,临床易现抽动共患焦虑;脾虚肝旺累及至肾,痰浊内生,临床易现抽动共患抑郁。本文旨在为TD及其共患病的诊疗提供新的思路,简化诊疗思维,以期提高临床医生对TD及相关共患病的认识。Tic disorder(TD) is a neurodevelopmental disease that starts in childhood and mainly presents with tic symptoms.Its clinical manifestations are diverse and can be accompanied by a variety of comorbidities,which increase the complexity and severity of the disease.Under the guidance of the overall thought of traditional Chinese medicine,the core pathogenesis of spleen deficiency and liver hyperactivity is emphasized,and the particularity of comorbidities can be considered on the basis of overall syndrome differentiation.Spleen deficiency and liver hyperactivity often influences the lung,with qi stagnation changes,and is prone to tic and hyperactivity in clinic.Spleen deficiency and liver hyperactivity influences the heart,and has fire evil internal disturbance,which is prone to tic and anxiety in clinic.Spleen deficiency and liver hyperactivity influences the kidney,phlegm is endogenous,and is prone to tic and depression.This paper aims to provide new ideas for the diagnosis and treatment of tic disorder and its comorbidities,simplify the diagnosis and treatment thinking,and improve the understanding of TD and related comorbidities among clinicians.

关 键 词：抽动障碍 共患病 以证统病 异病同治 脾虚肝旺 

分 类 号：R273[医药卫生—中西医结合]