中医药研究论丛

201.6注意力缺陷过动症之中医文献回顾

 

注意力缺陷过动症之中医文献回顾
Literatures Review of Attention Deficit Hyperactivity Disorder in Traditional Chinese Medicine
吕桓毅1 吴龙源1 蔡金川1,2 林立伟1*
1 义守大学学士後中医学系,高雄,台湾
2 义大医疗财团法人义大医院中医部,高雄,台湾
【摘要】
「注意力缺陷过动症」(Attention Deficit Hyperactive Disorder,简称为ADHD)。它是儿童精神疾病中最常见的疾病,根据临床表现分为注意力不集中型、过动—冲动型、复合型三种。ADHD 的发病原因及病理机转还没有非常确定,主要认为与遗传、中毒、环境、营养等因素有关。本文主要目的在蒐集近十年中医治疗注意力缺陷过动症的文献,透过研究文献的整合及归纳,提出临床最常见的证型以及治疗用方,供临床医师作为叁考。
中医古代文献中无本病的专门论述,根据临床表现,属於“风证”、“健忘”、“烦躁”等范畴,并认为本病的病因为先天禀赋不足,後天失调,或他病所伤。病机为脏腑功能失常,阴阳失调。脏腑功能失常是其主要病理改变,阴静不足、阳动有馀是其主要病机特点。本病与心、肝、脾、肾四脏关系密切。心脾两虚、痰热内扰、肝肾阴虚、肝脾不合、心肾不足等为ADHD常见之证型,常用方有归脾汤、黄连温胆汤、知柏地黄丸、加味消遥散、右归丸等供临床随证加减应用,有关其相关的药理作用机理,仍有待未来进一步阐明。
【关键词】
注意力缺陷过动症、辨证分型、中医
 
Huan-Yi LU1 Lung-Yuan WU1 Chin-Chuan Tsai1,2 Li-Wei Lin1*
1The School of Chinese medicine for Post Baccalaureate of I-Shou University, Kaohsiung, Taiwan
2The Department of Chinese medicine of E-DA Hospital, Kaohsiung, Taiwan
【Summary】
Attention deficit hyperactivity disorder(ADHD)is one of the most common neuropsychiatric disorders in children characterized by a triad of symptoms involving age-inappropriate behaviors with attention, impulse controls and hyperactivity. The prevalence of ADHD in Taiwan is 7%-8%. A higher prevalence is often reported in males 14.9% than females 4.5%. The etiology and pathogenesis of ADHD is still unclear. Factors that may be involved in the development of ADHD include hereditary, toxic chemicals, environment and nutrition. Through literature review, the aim of this study was to summarize the most common clinical phenotypes and drugs for clinical reference.
There is no record about ADHD in classics of traditional Chinese medicine (TCM)before. According to the clinical presentations, it can belong to the“winds”, “forgetfulness” , “irritability” of TCM. The etiology and pathogenesis of ADHD in TCM can be discussed in four aspects: heart, liver, spleen and kidney.Also, the syndrome of the disease can be classified to“dual deficiency of the heart-spleen”,“phlegm-fire harassing the heart” , “liver-kidney yin deficiency”,“insufficiency of kidney essence” and “liver depression and spleen deficiency”. There are many Chinese herbs formulas used on ADHD patients such as “Gui Pi Tang”,“Huanglian Wendan Tang”, “Zhi-Bai-Di-Huang-Wan”,“Jia-Wei-Xiao-Yao-San”and“Yougui Pill”. In conclusion, TCM has benefit for ADHD treatment and may help to avoid side effect related to conventional medication.
Keywords:Attention deficit hyperactivity disorder, differential diagnosis,traditional Chinese medicine