基于通阳理论与现代医学视角探讨治疗寒地小儿神经性尿频的诊疗思路
Exploring the Diagnostic and Therapeutic Strategies for Pediatric Neurogenic Pollakiuria in Cold Regions: From the Perspectives of “Tongyang” Theory and Modern Medicine
DOI: 10.12677/acm.2025.1592694, PDF,   
作者: 朱 杰, 张语倩, 王晓畅:黑龙江中医药大学研究生院,黑龙江 哈尔滨;王有鹏*:黑龙江中医药大学附属第二医院儿科,黑龙江 哈尔滨
关键词: 通阳理论神经性尿频寒地中医儿科Yang-Activating Theory Neurogenic Urinary Frequency Cold Areas Pediatrics of Traditional Chinese Medicine
摘要: 小儿神经性尿频(Neurogenic Urination, NU)是儿科常见的泌尿系统疾病。主要表现为尿频,部分患儿可伴尿急,无尿痛、遗尿、排尿困难、发热及浮肿等情况。本文以现代医学对神经性尿频的病理生理学认知为基础,结合寒地地域特性与小儿体质特征,将“通阳理论”与寒地小儿神经性尿频的病因病机相结合,对寒地小儿神经性尿频的诊疗提出独特见解。在阐释“通阳理论”的科学内涵的同时,将其贯穿于小儿神经性尿频治疗的始终,并取得显著疗效。
Abstract: Pediatric neurogenic urination (NU) is a prevalent urological disorder in children, primarily characterized by frequent urination, with some cases accompanied by urinary urgency. Notably absent are dysuria, enuresis, difficulty in urination, fever, or edema. This study, grounded in modern medical understanding of NU’s pathophysiology and incorporating the climatic characteristics of cold regions and pediatric constitutional traits, integrates the “Yang-Unblocking Theory” with the etiology and pathogenesis of NU in children from cold areas. It proposes novel diagnostic and therapeutic insights. By elucidating the scientific rationale of the Yang-Unblocking Theory and consistently applying it throughout NU treatment, significant clinical efficacy has been achieved.
文章引用:朱杰, 张语倩, 王晓畅, 王有鹏. 基于通阳理论与现代医学视角探讨治疗寒地小儿神经性尿频的诊疗思路[J]. 临床医学进展, 2025, 15(9): 1863-1869. https://doi.org/10.12677/acm.2025.1592694

参考文献

[1] 袁斌, 王璐, 赵长江. 中医儿科临床诊疗指南∙神经性尿频(制订) [J]. 中医儿科杂志, 2017, 13(2): 1-4.
[2] Braga, A.A.N.M., Veiga, M.L.T., Ferreira, M.G.C.d.S., Santana, H.M. and Barroso Jr, U. (2019) Association between Stress and Lower Urinary Tract Symptoms in Children and Adolescents. International braz j urol, 45, 1167-1179. [Google Scholar] [CrossRef] [PubMed]
[3] Austin, P.F., Bauer, S.B., Bower, W., Chase, J., Franco, I., Hoebeke, P., et al. (2015) The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Update Report from the Standardization Committee of the International Children’s Continence Society. Neurourology and Urodynamics, 35, 471-481. [Google Scholar] [CrossRef] [PubMed]
[4] Franco, I. (2012) Functional Bladder Problems in Children: Pathophysiology, Diagnosis, and Treatment. Pediatric Clinics of North America, 59, 783-817. [Google Scholar] [CrossRef] [PubMed]
[5] Chien, C., Yu, H., Lin, T., Lai, M. and Hsu, S. (2003) Substance P via NK1 Receptor Facilitates Hyperactive Bladder Afferent Signaling via Action of Ros. American Journal of Physiology-Renal Physiology, 284, F840-F851. [Google Scholar] [CrossRef] [PubMed]
[6] Zheng, Y., Yin, L., Wang, X., Zhao, C. and Du, Y. (2024) Prevalence and Allergy-Related Risk Factors of Overactive Bladder in Children in Northeast China. Frontiers in Public Health, 12, Article 1415833. [Google Scholar] [CrossRef] [PubMed]
[7] Reisch, B., Das, R., Gardner, B. and Overton, K. (2021) Cognitive Components of Behavioral Therapy for Overactive Bladder: A Systematic Review. International Urogynecology Journal, 32, 2619-2629. [Google Scholar] [CrossRef] [PubMed]
[8] Zillioux, J., Welk, B., Suskind, A.M., Gormley, E.A. and Goldman, H.B. (2022) SUFU White Paper on Overactive Bladder Anticholinergic Medications and Dementia Risk. Neurourology and Urodynamics, 41, 1928-1933. [Google Scholar] [CrossRef] [PubMed]
[9] 周思远, 张芹, 张心爱, 等. 通阳法在冠心病治疗中的应用[J]. 中西医结合心脑血管病杂志, 2024, 22(20): 3715-3717.
[10] (清)程国彭, 原著, 田代华, 等, 点校. 医学心悟[M]. 天津: 天津科学技术出版社, 1999.
[11] 梅琼, 曾祥法. 浅析通阳理论及治法运用[J]. 湖北中医药大学学报, 2021, 23(6): 47-50.
[12] 郝建军, 张介眉, 冯云霞, 等. 通阳理论的历史沿革[J]. 中西医结合研究, 2011, 3(2): 104-106.
[13] 朱大年, 等. 生理学[M]. 上海: 复旦大学出版社, 2015
[14] 李文杰. 社会心理压力对个体HPA轴反应的影响和性别差异[J]. 社会科学前沿, 2023, 12(6): 3475-3480.
[15] 蒋力生. 中医“证”研究的思路与方法(续) [J]. 云南中医杂志, 1991, 12(3): 1-8.
[16] Tae, B.S., Park, T.Y., Jeon, B.J., Chung, H., Lee, Y.H., Park, J.Y., et al. (2019) Seasonal Variation of Overactive Bladder Symptoms in Female Patients. International Neurourology Journal, 23, 334-340. [Google Scholar] [CrossRef] [PubMed]
[17] 郭峥, 侯一鸣, 潘光霞, 等. 寒地儿科流派辨体思想概述[J]. 辽宁中医杂志, 2022, 49(8): 52-54.
[18] 展照双, 王加锋. “到气才可清气”对抗生素滥用及不良反应的临床指导意义[J]. 山东中医杂志, 2019, 38(5): 410-413.
[19] 潘宇政, 陈业强, 陈永斌, 等. 阴虚、阳虚、气虚证病人免疫功能的变化[J]. 广西医科大学学报, 1999, 29(2): 16-18.
[20] 戴恩来, 李小会, 余仁欢, 等. 从湿热论治肾脏病的思路与方法[J]. 中国中西医结合肾病杂志, 2021, 22(5): 468-470.
[21] Shimizu, T., Shimizu, S., Higashi, Y., Yoshimura, N. and Saito, M. (2020) Central Regulation Mechanisms for Stress-Induced Frequent Urination. Folia Pharmacologica Japonica, 155, 20-24. [Google Scholar] [CrossRef] [PubMed]
[22] 丁旭阳, 刘喜德. 刘喜德“诸病多兼肝郁”临床诊疗思路[J]. 浙江中西医结合杂志, 2024, 34(11): 1065-1067.
[23] 杨红利. “通阳不在温, 而在利小便”在慢性肾脏病治疗中的运用[J]. 中国民间疗法, 2021, 29(23): 4-6.
[24] 卢杨君, 陈磊, 伍春桃, 等. 白术多糖对CUMS模型小鼠抑郁样行为及其脑肠轴和HPA轴的影响[J]. 天然产物研究与开发, 2025, 37(1): 1-9.
[25] 郭其乐, 吴晓燕, 唐亚荣, 等. 补中益气汤合五苓散加减治疗肛肠病术后不完全性尿潴留临床研究[J]. 中医学报, 2014, 29(1): 108-109.
[26] 张国伟. 猪苓质量控制及其利水功效在BBN诱导的大鼠膀胱癌治疗中机制研究[D]: [博士学位论文]. 广州: 广州中医药大学, 2010.
[27] 梁志健, 江伟雯, 操红缨, 等. 缩泉丸质量标准的初步研究[J]. 中药新药与临床药理, 2015, 26(2): 236-239.
[28] 刘盼英, 杨康, 杨洪涛. 金樱子在肾脏疾病治疗中的作用[J]. 中医学, 2020, 35(6): 1196-1201.
[29] 杨校, 刘治彤, 王丽, 等. 重构本草——金樱子[J]. 长春中医药大学学报, 2024, 40(2): 140-143.
[30] 郑晓佳, 张乃霖, 石芳, 等. 基于“通阳不在温”论治慢性萎缩性胃炎之胃凉的思考[J]. 中国中医基础医学杂志, 2021, 27(4): 664-666.
[31] 张宁. 基于脾胃与肠道菌群的相关性从记忆角度研究“脾藏意” [D]: [博士学位论文]. 北京: 北京中医药大学, 2020.
[32] 王瑜, 陈昺伃, 王彦华. 柴胡加龙骨牡蛎汤通过神经递质及食欲素改善失眠伴焦虑的作用机制研究[J]. 辽宁中医药大学学报, 2025(27): 1-7.
[33] 文誉坤, 陈春妹, 张福利. 温胆汤及其类方治疗抑郁症的研究进展[J]. 江苏中医药, 2021, 53(12): 74-77.