基于“肝强脾弱”理论论治儿科疾病的临床探析

Clinical Analysis of Pediatric Diseases Treatment Based on the “Liver Excess and Spleen Deficiency” Theory

摘要: “肝强脾弱”是中医儿科的核心病机之一，源于五行生克理论，强调肝木亢盛克制脾土，导致脾胃功能失调。本文系统梳理了该理论的经典溯源，结合《黄帝内经》《小儿药证直诀》等古籍，阐释其“肝常有余，脾常不足”的儿科证候特点，并总结“泄肝扶脾、调和木土”的治疗原则及方药应用。同时探讨外治法与现代医学机制的结合，通过临床验案验证中西医协同治疗儿童抽动症等疾病的疗效。研究指出，基于“肝强脾弱”理论的“调肝实脾、身心同治”策略，可为儿科疾病防治提供特色路径，并强调“治未病”理念在脾胃调护中的重要性。

Abstract: “Liver excess and spleen deficiency” is one of the core pathogenesis theories in traditional Chinese medicine pediatrics. Originating from the Five Elements generation and restriction theory, it emphasizes that exuberant liver wood restricts spleen earth, leading to dysfunction of the spleen and stomach. This paper systematically reviews the classical origins of this theory, elucidates its pediatric syndrome characteristics of “the liver is frequently excessive, while the spleen is frequently insufficient” by referencing ancient texts such as Huangdi Neijing (Yellow Emperor’s Inner Canon) and Xiao’er Yaozheng Zhijue (Key to Therapeutics of Children’s Diseases), and summarizes the therapeutic principle of “dredging the liver and fortifying the spleen, harmonizing wood and earth” along with the application of herbal formulas. Meanwhile, the integration of external therapies and modern medical mechanisms is discussed, and the efficacy of integrated Chinese and Western medicine in treating pediatric tic disorders and other diseases is verified through clinical cases. The study indicates that the strategy of “regulating the liver and tonifying the spleen, treating both body and mind” based on the “liver excess and spleen deficiency” theory can provide a distinctive approach for the prevention and treatment of pediatric diseases, and emphasizes the importance of the “treating disease before it arises” concept in the regulation and care of the spleen and stomach.