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小儿夜啼是小儿常见的一种病症，是指小儿白天能安静入睡，但不明原因的入夜啼哭不安，时哭时止，或每夜定时啼哭，甚则通宵达旦(1,2)。本病多见於新生儿及六个月内的婴儿，偶尔可见到较年长（如三到五岁）的患儿。婴幼儿常以啼哭表达要求或痛苦，饥饿、惊恐、尿布潮湿、过冷或过热、衣带过紧、皮肤搔痒等均可引起啼哭，此时若喂以乳食、安抚、更换潮湿尿布、调整衣被厚薄後，啼哭可很快停止，不属病态。
中医根据临床症状，将小儿夜啼分为五个主要常见证型，分别为「脾经虚寒」、「伤食积滞」、「心肝积热」、「心肝血虚」、「惊恐伤神」，临床上依据不同证型进行治疗(3-6)。同时也应详细询问病史，仔细进行理学检查，必要时转诊西医小儿科安排进一步检查，以排除婴幼儿因各种疾病（如中枢神经系统感染、颅内出血、癫癇、肠胃道急性感染或消化不良、脱水、肠套叠、肠阻塞、疝气、感冒、流感、疱疹性咽峡炎、中耳炎、皮肤感染、发热、外伤等）所造成的病理性啼哭，以免贻误患儿病情。
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Night cry is a common pediatric sleep disorder in children. Our case is a 2-year-5-month-old girl presented with night cry and atopic dermatitis. “Spleen is often insufficient in children”, and dietary irregularities will cause a weakening of the spleen’s movement and transformation function, causing food stopped in middle-jiao, gas blocked, fire made and spirit perplexed based on the theory of “ Disorder of the stomach leading to insomnia with restlessness. ”
The common syndromes of Pediatric Night Cry include “cold and gas stopped spleen”, “accumulated heat in heart”, “milk stagnant and frightened spirit”. The treatment includes “warming spleen to disperse cold”, “clearing heart to relieve restlessness”, “invigorating spleen to regulate stomach”, “arresting convulsion to stop crying”, “treatment from the liver pathogenesis”, “treatment from the
gallbladder pathogenesis.”
【Keywords】Night Crying, Itching, Chinese Medicine
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99.8 中医治疗小儿夜啼
