儿童注意缺陷多动障碍的中医临床证治特点及规律初探-附宁神颗粒治疗ADHD肾虚肝亢型临床疗效观察314例-中医儿科学专业论文.docxVIP

中文摘要 目的：从中医基础理论出发探讨儿童注意缺陷多动障碍的证治规律，为中医临 床辨证分型及规范化研究提供依据。客观评价以“滋肾平肝，益智宁神”法为依 据研制的宁神颗粒治疗本病“肾虚肝亢型”的有效性、安全性。 方法：以中医基础理论为依据，通过复习文献及总结导师的临床经验，结合小 儿生理病理特点，从 病因病机、病变脏腑、症候特点及临床证治等多角度对本病 进行论述。 选取符合ADHD“肾虚肝亢型”纳入标准的患儿314例，按照随机双盲多中心 的原则，探讨宁神颗粒治疗本证的临床疗效。 结论：“脏腑柔弱，阴阳稚嫩，神气怯弱”是小儿对本病具有易感性的体质基 础和内在因素。“阴阳失调，阴静不足，阳动有余”是本病的主要病机特点，病 位在脑，主要涉及肾肝心脾。中医辨证以“肾虚肝亢”型为其主要证型，临床观 察表明，宁神颗粒可针对ADHD的发病特点进行施治，对多动不宁、神思涣散、多 言多语、性急易怒、手足心热、口干咽躁等肾虚肝亢症状均有明显疗效，其中对 多言多语、手足心热、盗汗、大便秘结的疗效，试验组优于对照组。整体调节作 用强，近期疗效可靠，临床验证其副作用少。 关键词：儿童注意缺陷多动障碍 病机 症候特点 辨证论治 疗效观察 ABSTRACT Objective: To explore the characteristics and the law of the clinical syndrome phenotype based TCM for the children of Attention Deficit Hyperactivity Disorder, and provide a standardized basis for the clinical syndrome phenotype . To objectively evaluate the effects and securitis treated the Deficiency of Kidney and Hyperactivity of Liver with ningshen particles. Methods：In the first part of this thesis，through reviewing literature and summarying my tearch’s experience, According to physiological characteristics of children, I discussed ADHD in different aspects, such as pathogenesis, pathogenic mechanisms, correlative viscera, syndrome differentiation and treatment laws. In the second part, 314 patients sufering from ADHD，diagnosed by the golden criteria for Deficiency of Kidney and Hyperactivit y of Liver, were divided randomly into two groups, to explore the clinical effects of ningshen particles. Conclusions: Tender Viscera, Fine Yin-Yang ,Weak Spirit-Qi are basic corporeity and inner factors. Imbalance of Yin-Yang is the ADHD’s main pathogenesis. ADHD can be chassified into four types. Deficiency of Kidney and Hyperactivity of Liver is the main differentiation of symptoms and signs. Practises show, that the drug has better adjustment action for disease on the basis of body as a whole, and it has reliable short-terme fect, few ill-effects. Key words: Attention Deficit