关键词: 抽动障碍, 注意缺陷多动障碍, 中医理论, 病因病机, 辨证论治, 儿童

Abstract:

Tic disorders comorbid with attention deficit hyperactivity disorder (ADHD) is a common comorbidity of neurodevelopmental disorders in children. The core symptoms are motor/vocal tics, attention deficit and hyperactive impulsivity, which seriously affect the psychological and social functions of children. Atomoxetine and clonidine are the main drugs in western medicine treatment, but their clinical use is limited due to gastrointestinal and cardiovascular adverse reactions. Traditional Chinese medicines have the advantages of fewer adverse reactions and stable curative effect, which are easily accepted by the parents of children. For this disease, traditional Chinese medicine believes that its etiology is closely related to insufficient endowment, improper diet, emotional disorder, and invasion of external pathogens. The basic pathogenesis lies in the dysfunction of viscera and the imbalance of Yin and Yang, especially the "liver hyperactivity generating wind", which is the key. As a direct factor leading to tic symptoms, wind pathogen is often combined with sputum and fire and other pathological factors, forming a complex pathogenesis such as wind-sputum disturbance and wind-fire stimulation, which leads to the co-occurrence of tic symptoms with attention deficit and hyperactive impulse symptoms. Clinically, based on the pathogenesis, it can be divided into five main syndrome types: syndrome of liver wind carrying phlegm, syndrome of kidney deficiency and liver hyperactivity, syndrome of external wind causing activity, syndrome of latent fire in spleen and stomach and syndrome of heart and liver fire hyperactivity. The ultimate purpose of treatment is to harmonize Yin and Yang of viscera, and the core treatment principle of calming the liver and stopping wind is established. The pathological factors such as wind, phlegm and fire are concurrently managed according to the principle of "simultaneous application of principal and subordinate treatments". Based on different syndrome types, appropriate treatment principles and methods and prescriptions are selected for treatment.

Key words: Tic disorders, Attention deficit hyperactivity disorder, Traditional Chinese medicine theory, Etiology and pathogenesis, Treatment based on syndrome differentiation, Child