从《黄帝内经》核心观念论治儿童多动症的理论与临床探析

Exploring the Theory and Clinical Approach to Treating ADHD in Children Based on the Core Concepts of the Huangdi Neijing

摘要: 儿童注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)是儿童期常见的神经发育障碍性疾病，临床以注意力不集中、多动冲动为核心特征，严重影响患儿的学习、社交及心理健康。本文以《黄帝内经》核心观念为理论基石，系统梳理了“象”思维、阴阳学说、脏腑藏神理论、开阖枢气化理论以及“肾–髓–脑”轴等经典理论在儿童ADHD诊疗中的指导价值。研究认为，儿童ADHD的核心病机可概括为“风象、火象有余，土象、水象不足”，根本在于阴阳动态失衡，具体表现为“阳动有余、阴静不足”，病位主要在心、肝、脾、肾，与五脏藏神功能异常密切相关。治疗当以燮理阴阳为总纲，遵循“和五脏、畅五神”的基本原则，依据六经气化理论实施开阖枢分治策略。本文结合现代临床研究证据，为中医药治疗儿童ADHD提供经典理论支撑与实践参考。本文属于理论述评与文献研究，兼有假说提出性质，未开展原创临床数据采集与统计分析。

Abstract: Attention deficit hyperactivity disorder (ADHD) in children is a common neurodevelopmental disorder during childhood, clinically characterized by inattention, hyperactivity, and impulsivity, which seriously affects children’s learning, social life, and mental health. This article is based on the core concepts of the Huangdi Neijing (Yellow Emperor’s Inner Canon) and systematically reviews the guiding value of classic theories such as “image” thinking, Yin-Yang theory, Zang-Fu organ and spirit theory, opening-closing and pivot qi transformation theory, and the “kidney-marrow-brain” axis in the diagnosis and treatment of pediatric ADHD. The study suggests that the core pathogenesis of ADHD in children can be summarized as “excess of wind images and fire images, deficiency of earth images and water images”, fundamentally rooted in the dynamic imbalance of Yin and Yang. Specifically, it is manifested as “excess Yang movement and insufficient Yin calmness”, with the main affected organs being the heart, liver, spleen, and kidneys, closely related to dysfunction of the spirit-storing functions of the Five Zang organs. Treatment should focus on harmonizing Yin and Yang, following the basic principle of “balancing the five organs and unblocking the five spirits”, and implementing opening-closing pivot differentiation strategies according to the Six Meridians Qi Transformation theory. This article, combined with modern clinical research evidence, provides classical theoretical support and practical reference for TCM treatment of pediatric ADHD. This article is classified as a theoretical critique and literature review, incorporating elements of hypothesis generation, without engaging in original clinical data collection or statistical analysis.