基于三焦脏腑功能失衡探析儿童注意缺陷多动障碍的治疗思路

Exploration of Treatment Approaches for Attention-Deficit/Hyperactivity Disorder in Children Based on Imbalance of Sanjiao (Triple Energizer) Zang-Fu Organ Functions

摘要: 本文认为小儿先天禀赋不足，或后天饮食不节、情绪失调等养护不当，会导致三焦脏腑功能失常，阴阳失衡，阳动有余，阴津不足，发为ADHD。三焦脏腑功能失衡主要有三个病机发展方向：1) 三焦气化失司，津液运行失常化生痰湿，上蒙清窍；2) 三焦相火妄动，邪热内生，阴阳失衡，扰及心神；3) 三焦输布障碍，气血精津液不达五脏，致使脏腑失于濡养，所主五神情志失调，可导致患儿注意缺陷多动障碍。治疗上首当平衡阴阳，以调和三焦脏腑功能，调畅三焦气机为要，结合宁神益智之品，使三焦气化如常，水谷精微布散有序，后天之精充养先天，气血充足，阴平阳秘，五脏调和，以改善注意力缺乏、冲动、多动等症状。本文从中医三焦气化角度探讨儿童ADHD的病机及治疗，以期为临床治疗ADHD提供参考。

Abstract: This paper posits that in children, congenital endowment deficiency or improper nurturing due to factors such as inappropriate dietary habits and emotional imbalances in later life can lead to dysfunction of the Sanjiao zang-fu organs, resulting in an imbalance of yin and yang, with excessive yang activity and insufficient yin fluid, thereby manifesting as ADHD. There are three main pathogenic mechanisms associated with the imbalance of Sanjiao zang-fu organ functions: 1) Dysfunction of qi transformation in the Sanjiao leads to abnormal movement of body fluids, generating phlegm-dampness that obscures the orifices; 2) Uncontrolled ministerial fire in the Sanjiao gives rise to internal pathogenic heat, disrupting the balance of yin and yang and disturbing the mind; 3) Impaired transportation and distribution in the Sanjiao prevent the proper delivery of qi, blood, essence, and body fluids to the five zang organs, resulting in inadequate nourishment of the organs and dysregulation of the five emotions and mental activities they govern, which can lead to attention-deficit/hyperactivity disorder in children. In treatment, the primary focus should be on balancing yin and yang, harmonizing the functions of the Sanjiao zang-fu organs, and regulating the qi movement of the Sanjiao. This should be combined with the use of herbs that calm the mind and enhance intelligence, ensuring normal qi transformation in the Sanjiao, orderly distribution of nutrients from food and water, replenishment of congenital essence with acquired essence, sufficient qi and blood, a balanced state of yin and yang, and harmonious functioning of the five zang organs, thereby improving symptoms such as lack of attention, impulsivity, and hyperactivity. This paper explores the pathogenesis and treatment of ADHD in children from the perspective of qi transformation in the Sanjiao in traditional Chinese medicine, aiming to provide references for clinical treatment of ADHD.