Abstract:

Severe adenoid hypertrophy (AH) is frequently comorbid with attention deficit hyperactivity disorder (ADHD), and the two conditions interact to form a vicious cycle. Chronic cerebral hypoxia induced by persistent sleep-disordered breathing secondary to severe AH may be associated with the aggravation of ADHD manifestations. Professor Jiang Zhiyan, the fourth-generation inheritor of the Shanghai School of Traditional Chinese Medicine (TCM) "Xu's Pediatrics", believes, from the comorbidity perspective, that the core pathogenesis of comorbid severe AH and ADHD lies in impaired transportation of spleen, phlegm nodules obstructing the orifices, and spleen deficiency with liver hyperactivity. Impaired transportation of spleen leads to internal generation of phlegm-dampness, and obstruction of the nasal orifices by phlegm-turbidity results in AH; spleen deficiency-induced malnutrition and hyperactivity of liver-wood disturb the mind, manifesting as ADHD symptoms such as inattention, hyperactivity, and impulsivity. Based on this, Professor Jiang has proposed the theory of "regulating the spleen to treat nasal disorders" and formulated the prescription of regulating spleen, resolving phlegm and unblocking orifices. With restoring the spleen's function of transportation as the fundamental goal, this prescription improves the pathological basis for the formation of phlegm and blood stasis at the root causes, while simultaneously exerting the effects of suppressing hyperactivity and soothing the liver to regulate ADHD symptoms. Clinical practice has demonstrated that this prescription can effectively relieve severe AH-related manifestations and alleviate ADHD-associated symptoms, offering a novel therapeutic approach for the traditional Chinese medicine management of severe AH complicated with ADHD.

Key words: Severe adenoid hypertrophy, Attention deficit hyperactivity disorder, Comorbidity, Regulating the spleen to treat nasal disorders, Child