| 引用本文: |
张梦洁, 王俊宏, 闫雨柔, 翟睿, 姜妍琳.基于“四时五脏阴阳”辨治抽动障碍共患注意缺陷多动障碍[J].湖南中医药大学学报,2026,46(4):783-788[点击复制] |
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| 基于“四时五脏阴阳”辨治抽动障碍共患注意缺陷多动障碍 |
| 张梦洁,王俊宏,闫雨柔,翟睿,姜妍琳 |
| (北京中医药大学东直门医院北京 100700) |
| 摘要: |
| 抽动障碍与注意缺陷多动障碍均为儿童时期常见的神经精神类疾病，二病共患较为多见，且存在病程迁延、症状反复的诊疗难点。中医药在缓解患儿核心症状、减少病情反复、缩短病程等方面，具备一定的临床优势。本文立足于中医“四时五脏阴阳”核心理论，以四时邪气更迭的特点、五脏阴阳气血消长规律为切入点，深入探析不同季节下儿童抽动障碍共患注意缺陷多动障碍的症状波动规律，把控核心病机并辨证施治。春季风邪亢盛、湿邪侵袭，治疗应当祛风固表、平肝醒脾；夏季暑热较盛、痰湿内蕴阻滞气机，治疗应当清暑化痰、清心健脾；秋季燥邪偏盛、易耗伤肺津阴液，治疗应当养阴润燥、宣肺润肺；冬季寒邪侵袭、易损耗机体肾精，治疗应当散寒固表、藏养肾精。附临床验案一则以供参考。 |
| 关键词: 抽动障碍|注意缺陷多动障碍|四时五脏阴阳|儿童|共患病 |
| DOI：10.3969/j.issn.1674-070X.2026.04.018 |
| 投稿时间：2025-08-07 |
| 基金项目:国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]129号) |
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| Differentiating and treating tic disorder comorbid with attention deficit hyperactivity disorder based on the theory of "four seasons, five zang organs, and yin-yang" |
| ZHANG Mengjie, WANG Junhong, YAN Yurou, ZHAI Rui, JIANG Yanlin |
| (Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China) |
| Abstract: |
| Tic disorder(TD) and attention deficit hyperactivity disorder(ADHD) are both common neuropsychiatric disorders in childhood. Comorbidity of these two conditions is frequently observed, and they present diagnostic and therapeutic challenges,including a prolonged disease course and recurrent symptoms. Chinese medicine has certain clinical advantages in alleviating core symptoms, reducing relapse rates, and shortening the disease course in affected children. Based on the core TCM theory of “four seasons, five zang organs, and yin-yang”, this paper takes the alternation characteristics of seasonal pathogenic factors and the law of waxing and waning of yin-yang, qi, and blood in the five zang organs as entry points, and conducts an in-depth analysis of the symptom fluctuation regulations in children with TD comorbid with ADHD across different seasons, so as to grasp the core pathogenesis and apply pattern identification and treatment accordingly. In spring, when wind pathogen is superabundant and dampness pathogen invades, the treatment should focus on dispelling wind, consolidating the exterior, calming the liver, and awakening the spleen. In summer, when summer-heat is prevalent and internal accumulation of phlegm-dampness obstructs qi movement, the treatment should focus on clearing summer-heat, resolving phlegm, clearing the heart, and strengthening the spleen.In autumn, when dryness pathogen is predominant and tends to consume lung fluids and yin, the treatment should focus on nourishing yin, moistening dryness, dispersing and moistening the lung. In winter, w hen cold pathogen invades and tends to consume kidney essence, the treatment should focus on dispelling cold, consolidating the exterior, and storing and tonifying kidney essence. A verified clinical medical record is appended for reference. |
| Key words: tic disorder|attention deficit hyperactivity disorder|four seasons,five zang organs,and yin-yang|children|comorbidity |
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