摘要
李宜瑞教授认为,儿童多动症临床阴虚阳亢者多见,往往又以心脾肾不足为其本,肝阳亢盛为其标。在辨证分型上,为执简驭繁,主要分为肾虚肝亢证、心脾不足证、痰热扰心证3证,肾虚肝亢证,主方为益智宁;心脾不足证,主方为四君子汤合甘麦大枣汤化裁;痰火扰心证,主方为温胆汤化裁。李教授认为,临床上各证型常混合存在,难于截然分开,例如心脾不足者,可出现土虚肝旺,或夹有痰湿或痰热。此外,证型也非一成不变,临证需细加斟酌。她还特别指出,调脾胃可安五脏,当上述各型"标"证已轻,脏腑"本"虚之证为主时,皆可酌加太子参、茯苓之类健脾药,脾健而其余四脏化源不绝。
Professor Li Yirui thinks that in clinical practice, children＇s attention deficient disorder is mainly manifested as yang hyperactivity due to yin deficiency, with heart-spleen-kidney deficiency as the root, hyperactivity of liver as the tip. On the dialectical typing, hyperactivity of liver due to kidney deficiency, heart-spleen deficiency, phlegm fire disturbing the heart are the most common types. For syndrome of hyperactivity of liver due to kidney deficiency, Yizhining （YZN） is mainly used ; For syndrome of heart-spleen deficiency, Modified Four Gentlemen Decoction in combination with Modified Licorice and Wheat and Jujube Decoction is mainly used; For syndrome of phlegm fire disturbing the heart, Modified Gallbladder-Warming Decoction is mainly used. According to Professor Li, many types of syndromes are often intermingled together in clinical practice, and hard to distinguish from each other. For example, in terms of heart-spleen deficiency, there is hyperactivity of liver due to spleen deficiency, or combined with phlegm dampness or phlegm heat. Besides, syndrome types are changing and need thinking over. She especially points out that regulating spleen and stomach can protect five zang organs. When the above various types＇ tips have lessened, the viscera deficiency has become the root, medicines for activating the spleen such as Taizishen （ Radix Pseudostellariae）, and Fuling （Poria） can be used to strengthen the spleen and protect the other four zang organs.
出处
《河南中医》
2017年第8期1356-1358,共3页
Henan Traditional Chinese Medicine
基金
国家自然科学基金项目(编号:81303006)
广州中医药大学第一附属医院李宜瑞名医工作室建设项目(编号:中医一院[2015]87号)
关键词
儿童多动症
肾虚肝亢证
心脾不足证
痰热扰心证
李宜瑞
attention deficient disorder
hyperactivity of liver due to kidney deficiency
heart-spleen deficiency
phlegm fire disturbing the heart
Li Yirui
