摘要
Abstract
Attention deficit hyperactivity disorder(ADHD)is the most prevalent behavioral and psychiatric disorder in childhood,characterized by inattentiveness,hyperactivity,emotional instability,impulsivity and willfulness,poor self-control,and varying degrees of learning difficulties,but with normal or essentially normal intelligence.Currently,the understanding on the pathogenesis of ADHD in traditional Chinese medicine(TCM)mostly stays at the macroscopic level of"Yin(阴)deficiency and Yang(阳)hyperactivity",and there is still a lack of systematic and in-depth interpretation of its core pathogenesis.In this study,in order to break through the traditional one-dimensional pathogenic dimension and broaden therapeutic approaches,the origin of ancient books is performed,combining with extensive clinical experience guided by mentor.Based on the theory of"the kidney stores essence and connects with the brain"of TCM,the functional connotations of"Zhi(志)"in the aspects of"storage""change",governing spirit-mind,and gathering souls is deeply analyzed,and the pivotal role of the"kidney essence-marrow sea-spirit-mind"axis in cognitive regulation is revealed.It is proposed that"deficiency of kidney essence,insufficiency of marrow sea,and Yang hyperactivity of heart and liver"is the core pathogenesis of the disease.Specifically,deficiency of kidney essence leads to delayed development of marrow sea,causing"Zhi"to lose its function of governing spirit-mind and gathering souls.At the same time,kidney-water is deficient and cannot moisten heart-fire upward,leading to Yang hyperactivity of heart and liver and the interaction of wind and fire,ultimately resulting in an imbalance of Yin and Yang in the body and cognitive and regulatory dysfunctions of the brain,manifested as core symptoms such as memory decline,attention deficit,and hyperactivity impulsiveness.In terms of treatment,it emphasizes the principles of coregulation of body and spirit,and treating both the symptoms and the root cause.It advocates taking"tonifying the kidney and filling essence,and enriching the marrow and benefiting Zhi"as the foundation,and combining the methods of"tranquilizing the heart and soothing the spirit-mind"and"soothing the liver and subduing Yang"to construct a comprehensive intervention strategy.This study aims to elucidate the core pathogenesis of ADHD,and highlight the unique value of TCM body and spirit co-treatment in neurodevelopmental disorder diseases,so as to provide new ideas and theoretical references for clinical practice.关键词
儿童/注意缺陷多动障碍/肾生髓,通于脑/肾精亏虚/髓海不足Key words
Children/Attention deficit hyperactivity disorder/Kidney generating marrow and connecting with the brain/Deficiency of kidney essence/Marrow sea insufficiency分类
医药卫生
