从肝脾论治过敏体质小儿抽动症的理论与实践探索

Theoretical and Practical Exploration on Treating Tic Disorder in Children with Allergic Constitution Based on the Theory of Liver and Spleen

摘要: 小儿抽动症是儿科常见的神经精神性疾病，近年来发病率逐渐升高，其中过敏体质患儿尤为多见，过敏状态可诱发或加重抽动症状。过敏体质小儿抽动症的核心病机在于“脾虚肝旺、风痰扰动”——脾虚为发病之本，肝旺为致病之标，过敏之“外风”与内风相合，形成“风痰搏结”的复杂病机。治疗上当以“培土抑木、熄风化痰”为基本大法，健脾化痰以固其本、平肝熄风以治其标、兼顾祛风脱敏、调和气血。本文梳理了从肝脾论治的理论源流，阐释了过敏与抽动的内在关联，总结了辨证论治体系与方药运用规律，并探讨了针灸、推拿等外治疗法的协同作用，以期为优化临床辨证论治方案提供参考。

Abstract: Pediatric tic disorder is a common neuropsychiatric condition in children, with an increasing incidence in recent years. Among affected children, those with an allergic constitution are particularly prevalent, as allergic status can induce or exacerbate tic symptoms. The core pathogenesis of tic disorder in children with allergic constitution lies in “spleen deficiency and liver hyperactivity, with wind-phlegm disturbance”—spleen deficiency constitutes the root of the disease, while liver hyperactivity represents the manifestation of the pathogenic process. The “external wind” associated with allergies combines with internal wind, forming a complex pathogenesis characterized by “wind-phlegm entanglement”. The therapeutic approach should be based on the fundamental principle of “strengthening the earth to suppress wood, extinguishing wind and resolving phlegm”, which involves strengthening the spleen and resolving phlegm to address the root cause, calming the liver and extinguishing wind to treat the manifestations, while also dispelling wind, alleviating allergies, and harmonizing qi and blood. This article reviews the theoretical origins of the liver-spleen-based treatment, explains the intrinsic relationship between allergies and tics, summarizes the syndrome differentiation and treatment system along with the principles of formula application, and explores the synergistic effects of external therapies such as acupuncture and tuina, aiming to provide a reference for optimizing clinical syndrome differentiation and treatment strategies.