从“调枢机”论治儿童抽动障碍  

Treating childhood tic disorder from the perspective of “regulating the pivot mechanism”

作　　者：乔俊艳 崔霞 丘婧 陈倩 QIAO Junyan;CUI Xia;QIU Jing;CHEN Qian(Miyun Campus,Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 101500;Third Affiliated Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学第三附属医院密云院区,北京100015 [2]北京中医药大学第三附属医院

出　　处：《现代中医临床》2025年第2期60-64,共5页Modern Chinese Clinical Medicine

基　　金：北京中医药大学第三附属医院密云院区院级科研项目(No.KJQ2023-001);北京市密云区基层中医药能力提升工程项目。

摘　　要：抽动障碍是儿童临床常见的神经精神障碍性疾病,临床以不自主的、无目的、快速的、刻板的一个或多个部位肌肉运动性抽动和(或)发声性抽动为主要临床表现。我团队认为本病多为“枢机不利、气机失调”所致,枢机不利为病机关键,少阳为阳枢,厥阴为阴枢,脾胃为人体气枢。少阳枢机不畅,阳气不得升发,内生郁热;厥阴枢机不利,肝失疏泄,气机壅塞,阴阳失调,生寒热错杂之病机;脾胃枢机失调,则一身之气郁滞而失其运化。临证重视调畅枢机,从肝脾论治该病。本文从枢机角度对抽动障碍的病机及治疗进行系统阐述。Tic disorder is a common neuropsychiatric disorder in children, characterized by involuntary, purposeless, rapid, and stereotypical motor tics and/or vocal tics in one or more body parts. Our team believes that this condition is mainly caused by “dysfunction of the pivot mechanism and imbalance of qi movement.” Dysfunction of the pivot mechanism is a key pathological factor. The shaoyang is the yang pivot, the jueyin is the yin pivot, and the Spleen-Stomach system is the body's qi pivot. When the shaoyang pivot is obstructed, the yang qi fails to rise, leading to the internal generation of stagnant heat. When the jueyin pivot is impaired, the liver loses its ability to regulate, qi movement becomes obstructed, and the imbalance of yin and yang leads to a complex pathology of cold and heat. When the spleen-stomach pivot is disrupted, the body's qi becomes stagnant, impairing its transformation and transportation. The treatment focuses on unblocking the pivot mechanism, primarily addressing the liver and spleen. This paper systematically elaborates the pathogenesis and treatment of tic disorder from the pivot mechanism perspective, aiming to provide new insights for the clinical management of this condition.

关 键 词：抽动障碍 儿童 精神疾患 调枢机 

分 类 号：R272.6[医药卫生—中医儿科学]