| 张思,韩斐.从“神发于心而交于肾”看儿童孤独症的中医治疗[J].浙江中医药大学学报,2024,48(9):1186-1190. |
| 从“神发于心而交于肾”看儿童孤独症的中医治疗 |
| How Traditional Chinese Medicine Treats Autism in Children: Based on Classical Theory “God Comes from the Heart and Gives to the Kidney” |
| DOI：10.16466/j.issn1005-5509.2024.09.021 |
| 中文关键词: 儿童孤独症 黄元御 《四圣心源》 识神 肾精 心肾相交 中医治疗 病案 |
| 英文关键词: childhood autism HUANG Yuanyu Sisheng Xinyuan spirit essence heart-kidney interaction traditional Chinese medicine treatment case study |
| 基金项目:国家中医药管理局基本中医药循证能力建设项目(60102)；北京市中医药科技发展资金项目(BJZYZD-2023-09)；中国中医科学院科技创新工程(CI2021A02506) |
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| 中文摘要: |
| [目的] 基于黄元御《四圣心源》“神发于心而交于肾”的理论分析儿童孤独症的中医治疗。[方法] 通过对黄元御《四圣心源》“神惊”与“精遗”两个章节的研读，结合儿童孤独症的临床症状表现，从心、肾各自生理病理和心肾相关理论着手，分析孤独症的关键病机，提出相应治法与用药，并附医案以资讨论。[结果] 儿童孤独症的“症-证”分析提示本病病在心、肾，关键病机为识神不发、肾精不足。基于黄元御“神发于心而交于肾......精藏于肾而交于心”的理论，神与精的功能发挥不仅在于心、肾各自功能正常，还赖于心肾关系正常。具体体现在心肾相关之精神互用、精血相生，君相安位，水火既济。因此，中医辨证论治，当施以益肾精、制心火，使精神互用、水火相济；强肾志、安心神，使君相安位；调中土升降，疏肝胆气郁，使气机升降得当，心肾交泰。文末所举儿童孤独症的病案辨证为肾精不足、虚火扰心证，治疗以补肾填精、清心安神，加减健脾益气、清泻肝火之品，取得较好临床疗效。[结论] 中医从协理心肾关系论治儿童孤独症，心肾得理则精足神旺，改善患儿社交、语言和行为异常，为今后儿童孤独症的临床治疗提供更广阔的思路和方法。 |
| 英文摘要: |
| [Objective] To analyze the traditional Chinese medicine(TCM) treatment of autism spectrum disorder(ASD) based on the theoretical perspective of “spirit originating from the heart and connecting with the kidneys”. [Methods] By studying the chapters “Shen Jing” and “Jing Yi” in HUANG Yuanyu’s Sisheng Xinyuan and combining these with the clinical symptoms of childhood autism， this paper analyzes the key pathogenesis of autism from the physiological and pathological perspectives of the heart and kidneys， and the related theories of heart-kidney interactions. Corresponding treatment methods and medications are proposed， accompanied by clinical cases for discussion. [Results] The syndrome analysis of childhood autism indicates that the disease primarily affects the heart and kidneys. The key pathogenesis involves insufficient development of the Shen (spirit) and deficiency of kidney essence. Based on HUANG Yuanyu’s theory that “Shen originates from the heart and communicates with the kidneys... essence is stored in the kidneys and communicates with the heart，” the functionality of the Shen and essence depends not only on the normal functioning of the heart and kidneys but also on the proper relationship between them. Specifically， this is reflected in the mutual use of spirit and essence， the generation of essence and blood， the stability of the monarch (heart) and minister (kidneys)， and the harmony of water and fire. Therefore， TCM treatment should focus on benefiting kidney essence and controlling heart fire to achieve mutual use of spirit and essence， and harmony of water and fire; strengthening kidney willpower and calming the spirit to stabilize the monarch and minister; regulating the middle earth to ascend and descend， and soothing liver and gallbladder Qi to ensure the proper movement of Qi and heart-kidney harmony. The case study presented involved a diagnosis of insufficient kidney essence and virtual fire disturbing the heart. The treatment focused on nourishing the kidneys， replenishing essence， clearing the heart and calming the spirit， with adjustments to strengthen the spleen， boost Qi， and clear liver fire， achieving satisfactory clinical efficacy. [Conclusion] TCM treatment of childhood autism from the perspective of regulating the heart-kidney relationship shows that proper heart-kidney coordination leads to sufficient essence and vigorous spirit， improving social， language and behavioral abnormalities in children. This provides broader ideas and methods for the clinical treatment of childhood autism in the future. |
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