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河南中医药大学 第一附属医院,郑州 450000
周荣易,博士,副教授,硕士生导师,从事中医药防治儿童精神神经系统疾病临床及研究工作,E-mail:zhourongyitcm@sina.com
马丙祥,博士,教授,博士生导师,从事中医药防治儿童精神神经系统疾病临床及研究工作,E-mail:mbx1963@126.com
收稿日期:2021-05-07,
网络出版日期:2021-10-11,
纸质出版日期:2021-11-20
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周荣易,马丙祥,周正等.从心脾论治孤独症谱系障碍中医机制探析[J].中国实验方剂学杂志,2021,27(22):208-214.
ZHOU Rong-yi,MA Bing-xiang,ZHOU Zheng,et al.Mechanism of Traditional Chinese Medicine in Treatment of Autism Spectrum Disorder Based on Heart and Spleen[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(22):208-214.
周荣易,马丙祥,周正等.从心脾论治孤独症谱系障碍中医机制探析[J].中国实验方剂学杂志,2021,27(22):208-214. DOI: 10.13422/j.cnki.syfjx.20212292.
ZHOU Rong-yi,MA Bing-xiang,ZHOU Zheng,et al.Mechanism of Traditional Chinese Medicine in Treatment of Autism Spectrum Disorder Based on Heart and Spleen[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(22):208-214. DOI: 10.13422/j.cnki.syfjx.20212292.
孤独症谱系障碍(ASD)为儿童时期常见的神经发育障碍性疾病,现代医学尚无特效药物,中医药辨证论治ASD研究日益增多且疗效可靠。心脾两脏为ASD辨证论治主要脏腑,而目前尚缺乏深入的中医机制分析。为探析ASD核心症状与心脾两脏的关系,本文针对性探讨心脾两脏在ASD核心症状形成中的中医理论渊源,从中医角度明确心脾两脏在ASD社会交流、交往障碍及行为异常刻板症状两大核心症状出现及发生发展中的作用。针对社会交流、交往障碍,基于心脾两脏功能、藏象理论、经络归属、经典论述提出并阐释ASD儿童语言问题、首责于心;有闻未应、脾意不充;孤僻自封、思伤心脾;脾运失职、心失所养、痰浊内生的中医心脾论机制。针对ASD儿童行为异常刻板症状产生机制,提出并阐释了脾常不足,运化失职,心神失养,心脾俱伤,心神不足而至刻板怪证连连的中医机理。通过对中医理论的剖析挖掘,为ASD从心脾论治探索理论依据,以期初步构建中医心脾两虚辨证论治ASD理论框架,为ASD中医辨证论治提供理论参考。从心脾辨证论治ASD具有雄厚的中医理论基础支撑,理法方药完备,可能是未来中医药治疗ASD研究的主要方向。
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder in childhood, whereas there is no specific medicine at present. There are more and more researches on the treatment of ASD with traditional Chinese medicine(TCM) which the curative effect is reliable. The heart and spleen are the main viscera for the treatment of ASD, but there is still a lack of in-depth analysis of the mechanism of TCM. In order to explore the relationship between the core symptoms of ASD and the heart and spleen, this article specifically explores the theoretical origins of the heart and the spleen in the formation of the core symptoms of ASD, and to clarify the role of the heart and spleen in the occurrence and development of the two core symptoms of ASD from the perspective of TCM. In view of social communication and communication obstacles, the author puts forward and explains the language problems of children with ASD based on the functions of the heart and spleen, the theory of the viscera, the ascription of the meridians, and the classics. The mechanism of the heart and spleen in TCM about the failure of the spleen, the loss of the heart, and the endogenous phlegm. Aiming at the mechanism of the stereotyped symptoms of abnormal behaviors in children with ASD, this paper proposes and explains the TCM mechanism of constant deficiency of the spleen and dereliction of duty, leading to loss of mind, heart and spleen injury, and finally a series of stereotypes and strange syndromes due to lack of spirit. Through the analysis and excavation of TCM theory, it explores theoretical basis for ASD from the theory of heart and spleen, with a view to preliminarily constructing the theoretical framework of TCM syndrome differentiation and treatment of the deficiency of both the heart and spleen, and provide theoretical reference for TCM syndrome differentiation and treatment of ASD. The treatment of ASD from the differentiation of symptoms and signs of the heart and spleen is supported by a strong theoretical basis of TCM, and the rationale, law and prescriptions are complete, which may be the direction of screening effective TCM prescriptions for the treatment of ASD in the future.
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