吴敏教授治疗儿童动障碍的用药规律研究.docVIP

吴敏教授治疗儿童抽动障碍的用药规律研究 张欣，吴敏（上海交通大学医学院附属新华医院 中医科，上海 200092） [摘要] 目的:总结吴敏教授治疗儿童抽动障碍的用药规律和学术思想。方法:构建抽动障碍患儿专科数据库，运用频数法等数理手段对祛风止动方的加减用药进行分析处理。结果:吴敏教授治疗儿童抽动障碍多使用苦辛、寒的药物，入肝肺经的药物居多，在祛风平肝的同时，常配伍健脾、安神之品，并针对不同的抽动症状对症用药。结论:吴敏教授以肝肺并调作为治疗抽动障碍的大法，临床用药以祛风熄风为主，并注重清散同治，兼顾培护小儿脾胃，兼施安神潜阳之法，临床疗效显著，为中医治疗抽动障碍提供了新的思路和借鉴。 [关键词] 抽动障碍；肝肺并调；吴敏；用药规律 THE STUDY ON MEDICINE RULE OF PROFESSOR WUMIN IN TREATING TIC DISORDERS Xin Zhang ，Min Wu Department of Chinese Traditional Medicine, Xinhua Hospital, Medicine School, Shanghai Jiaotong University, Shanghai 200092,China0bjective： To sum up the regularity of prescription and academic thought of professor Wumin in treating Tic Disorders．Methodsconstruct Microsoft Access database of Tic Disorders, all the data were analyzed by the statistical methods such as frequency method, etc. Results：Bitter, pungent and cold herbs are used frequently to treat Tic Disorders. Most herbs used converge to liver and lung intestine channel. The herbs of dispelling wind and calming the liver are used commonly matched with benefiting spleen and ceasing moods herbs according to different symptoms. Conclusion: Professor Wumin treat Tic Disorders by liver-lung harmonization therapy, mainly with herbs of dispelling wind and calming the liver. Pay attention to liver-clearing and Dispelling Wind, meanwhile give consideration to protecting spleen and stomach and tranquilization. Significant curative effect has got in clinic. The study provides new thought and reference for the treatment of tic disorders by traditional Chinese medicine. Key words：多巴胺受体阻滞剂氟哌啶醇等是治疗抽动障碍的首选药物，但由于许多患儿症状迁延，长期服药后副作用大，影响儿童的正常学习。中医从整体观念和辨证施治的理论着手，在治疗上显示了明显的优势，且已取得较好疗效。 导师吴敏教授师从儿科大家刘弼臣教授治疗抽动障碍的学术思想，创制祛风止动方显示能较快改善抽动症状，减轻氟哌啶醇毒副反应，总效率高达83.3%[]。符合《国际疾病分类》第10版 ICD-10 抽动障碍诊断标准；在本院门诊接受治疗并完成者；未用其他方法治疗者不符合诊断标准者;年龄 18岁者；有习惯性抽搐、肌阵挛性癫痫、风湿性舞蹈病、肝豆状核变性、脑外伤、脑炎后遗症和其他锥体外系疾病者；合并心血管、肝、肾、血液等严重疾病者；不能配合治疗或资料不全者。, 收集患者就诊资料, 包括中医症状、辅助检查、证候诊断和处方用药等信息, 设计抽动障碍病例资料数据库, 数据采用双对照录入。临床常用药物及其性味归经统计采用频数法,应用统计软件进行数据处理。 结 果 2.1 常用药物性味归经分析 使