医易及坎离视域下儿童注意缺陷多动障碍病机探微  

Exploring the pathogenesis of attention deficit hyperactivity disorder in children from the perspectives of traditional Chinese medicine,the Book of Changes,and the Kan-Li

作　　者：周康宁 王俊宏[1] ZHOU Kangning;WANG Junhong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《北京中医药大学学报》2025年第3期297-302,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82274581)。

摘　　要：古之医家,言医易同源者众多。医易皆关乎阴阳太极变化,易言事物阴阳变化之理,医言人体阴阳盛衰之机。本文基于对医易同源的思考,从医易及坎离视角出发,结合儿童生理特点,着重从心、肾、脾、肝论治儿童注意缺陷多动障碍。肾水之源,与其最有关者为心,为一体两用,故在肾之用,必推于心;养肾之方,必及于心,此含坎离相交、水火既济之理,此理数一致,实本乎天地生成之序。心居上,肾位下,下以奉上则精气上行,上以润下则神息下纳,肾与心互用,以成其生。基于儿童心常有余、肾常不足、脾常不足、肝常有余的生理特点,认为儿童注意缺陷多动障碍的病机乃肾水不足、中土虚衰致龙火上炎、失于潜藏,又因乙癸同源,水亏火起,致坎离失济。治疗上,应滋水填渊以导龙归海,补火助阳以引火归元,健运中气使水能停蓄,肝肾同治使坎离得济,以复于先天之太一,而还于有生之初。Many ancient physicians emphasized the shared origins of traditional Chinese medicine(TCM)and the Book of Changes,which are both deeply rooted in yin and yang transformations.While the Book of Changes explores alterations in yin and yang,TCM focuses on their manifestations in the human body.Based on these shared origins,this paper examines attention deficit hyperactivity disorder(ADHD)treatment in children through the perspectives of TCM,the Book of Changes,and the Kan-Li.This study integrates children′s unique physiological characteristics and emphasizes the pivotal role of the four zang viscera:the heart,kidney,spleen,and liver.In TCM,the kidney governs water metabolism and shares an intricate,interdependent relationship with the heart.Understanding the kidney′s functions and clinical implications necessitates accounting for its connection with the heart.Similarly,therapeutic interventions that nourish the kidney inherently involve heart regulation,reflecting the principle of the mutual rooting of water and fire through the interplay of Kan(water)and Li(fire).This fundamental view of TCM resonates with the natural laws of the universe and the interplay between Heaven and Earth.The heart occupies the upper position,whereas the kidney resides below.Kidney yin ascends to nourish the heart,whereas heart fire descends to warm the kidney,embodying a vital heart-kidney interaction essential for sustaining life.Based on the physiological characteristics of children,the heart qi tends to be hyperactive,kidney qi and spleen qi are frequently insufficient,and liver qi often displays hyperactivity.This study suggests that the pathogenesis of ADHD involves kidney essence insufficiency and spleen yang deficiency.Furthermore,the homogeny of the liver and kidney implies that kidney deficiency can result in upper hyperactivity of liver yang,leading to yin-yang disharmony.Treatment for ADHD in children should focus on invigorating the spleen and kidney,as well as tonifying and replenishing the liver and kidney,to reestablish

关 键 词：儿童 周易 注意缺陷多动障碍 病机 

分 类 号：R277.7[医药卫生—中医学]