自閉症兒童的中西醫觀點文獻探討

自閉症是一種以社交功能障礙與重複刻板行為為症狀表現的廣泛性發展障礙，根據世界衛生組織（WHO）統計世界上每100個兒童中有1位患有自閉症，隨著診斷標準的確立以及社會對此病的意識提升，發病率有逐年上升的趨勢。目前已知自閉症的病因與環境及遺傳因素有關，而具體病因病機尚未明確，且此病具高度異質性，目前治療方式根據患者多變的症狀而有所不同，其中包括行為治療、藥物以及另類療法，雖能改善部分的症狀，臨床上卻仍未發展出最有效治療核心症狀的方法。中醫認為自閉症屬於「童昏」、「語遲」等範疇，是由於先天不足，後天失養；腎精虧虛，心竅不通，神失所養，肝失調達，升發不利所致；其病位在腦，與心、肝、腎三臟有密切關係。根據不同的臨床症狀，以補腎填精、清心平肝、豁痰開竅，或益氣健脾、養心安神為治則，亦能併用針灸或推拿手法刺激穴位以開竅益智、醒神啟閉，達到標本同治。本文藉由文獻探討中西醫對自閉症病因病機與治療方式的觀點，提供更多治療想法，以期提升整體療效，幫助自閉症兒童之未來發展。

關鍵字

自閉症；語遲；行為治療；補腎填精；豁痰開竅

並列摘要

Autism spectrum disorder (ASD) is characterized with persistent deficits in social communication and interaction and restricted, repetitive patterns of behaviors, interests, or activities. According to World Health Organization, about one in 100 children has autism. The prevalence continues to rise because of better clinical diagnostic assessments and increased community concern. Environmental factors and genetical factors are believed to be related to ASD, but the exact etiology still remains unknown. Since ASD is highly heterogeneous, managements can be various and adapted to different patients. Behavioral therapies, medicines and alternative therapies have been widely conducted clinically. However, there has not been an effective way to cure the core symptoms. In theories of Traditional Chinese Medicine, ASD is considered as retardation in speaking. ASD is caused by congenital deficiencies and malnutrition of acquired essence, with different causes such as depletion of kidney essence, heart spirit confused by phlegm or liver depression. Brain, heart, liver and kidney are the associated organs. In order to treat both manifestation and root cause of disease, the principals of treatment can be invigorating kidney and nourishing essence, clearing heart fire and suppressing hyperactive liver, eliminating phlegm for resuscitation, invigorating spleen and replenishing qi or nourishing blood for tranquillization according to different clinical symptoms. Acupuncture or manipulation techniques can also be used for inducing resuscitation and benefiting intelligence by stimulation acupuncture points. In this article, we hope to provide more ideas for treating ASD and help more autistic patients by discussing different viewpoints in TCM and Western medicine.

並列關鍵字

Autism spectrum disorder ； retardation in speaking ； behavioral therapy ； invigorating kidney and nourishing essence ； eliminating phlegm for resuscitation

參考文獻

程艷然、熊振芳、盧金清、賀安妮、葉欣（2017）。中西醫結合干預自閉癥的研究現狀。湖北中醫雜誌。39(05)，63-66

Google Scholar

Matson, Johnny L., Kozlowski, & Alison M. (2011). The increasing prevalence of autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 418-425.