陶洪 周姗 彭昕欣 舒兰

    〔摘要〕 抽动障碍(tic disorder， TD)是儿童临床常见的难治性疾病之一，其发病机制复杂，诱因较多，易共患其他精神性疾病，目前缺乏疗效确切的治疗方案。国家级名中医舒兰认为TD的核心病机为风胜则动，提出“五脏六腑皆可致抽，非独在肝”的学术观点，以平衡脏腑功能、辨证与辨症结合为基本治疗原则。外风引动以疏风止痉、清热利咽为法，方选清解止抽方治疗;内风引动以平衡脏腑为法，常用导赤散、参苓白术散、泻黄散、龙胆泻肝汤、知柏地黄汤等加减治疗，并强调临证时需证症结合、相互兼顾。“平衡脏腑”“证症结合”的思想为儿童TD提供新的诊疗思路。

    〔关键词〕 抽动障碍;平衡脏腑;证症结合;清解止抽方;舒兰;医案

    〔中图分类号〕R272.6? ? ? ?〔文献标志码〕A? ? ? ? 〔文章编号〕doi：10.3969/j.issn.1674-070X.2023.06.017

    〔Abstract〕 Tic disorder (TD) is one of the common refractory diseases for children. It's characterized by complex pathogenesis， various triggers， and tending to be complicated with other psychiatric diseases. Yet， there has been no regimen with definite clinical efficacy currently. The national famous TCM practitioner SHU Lan， believes that the core pathogenesis of TD is "prevalence of wind gives rises to stirring"， and puts forward the academic view that "five zang organs and six fu organs can cause TD， not only the liver"， and takes balancing the function of zang-fu organs， combining pattern and symptom as the basic treatment principle. In accordance， TD caused by external wind is treated by relieving wind and stopping convulsions ......