兒童遺尿症之中醫辨證論治文獻探討

目的:兒童遺尿症屬於中醫“遺尿”的範疇，俗稱尿床，是指5歲以上的兒童，於睡眠期間不能自主地隨意排尿，少則數夜一次，多則可一夜數次，是常見的小兒泌尿道問題。本研究主要探討兒童遺尿症中醫藥辨證與治療的方法。材料及方法:本研究以中國醫學期刊網近十年中醫典籍期刊文獻為主要探討內容，探討中醫臨床治療兒童遺尿症的辨證論治模式，分別從辨證分型及各證型所常用的代表方藥，以期盼能提供臨床中醫辨證施治參考。結果:根據相關資料的分析結果，在兒童遺尿症的辨證分型上以腎氣不足，下元虛寒、脾肺氣虛、肝經濕熱及心腎不交為主要證型。治療方法有中藥方劑的治療、推拿治療法，針灸治療、穴位薰蒸法等。結論：在辨症分型治療上使用的方藥分別為（1）腎氣不足，下元虛寒型者常以菟絲子散或桑螵蛸散合縮泉丸治療，常用藥物為熟地黃、制附子、菟絲子、補骨脂、桑螵蛸；（2）脾肺氣虛型者常以補中益氣湯合縮泉丸治療，常用藥物為黃耆、黨參、白朮、升麻、益智仁；（3）肝經濕熱型者常以龍膽瀉肝湯治療，常用藥物為龍膽草、柴胡、黃芩、梔子、生地黃；（4）心腎不交型者常以導赤散合交泰丸治療，常用藥物為桑螵蛸、石菖蒲、遠志、茯神、當歸等方藥。以上對應證型藥方可供臨床醫師診斷處方用藥參考，至於其相關藥理作用機轉仍盼望於往後進一步加以探討。

關鍵字

兒童遺尿症；中醫辨證施治

並列摘要

Objective: From the Chinese Medicine point of view, nocturnal enuresis is refer to ＂Enuresis,＂ commonly known as bed-wetting, refers to five or more then five years children, urinating unvoluntarily during sleeping,ranging from only one severals nights, as many as several times one night. It is a common pediatric urinary problem. This study mainly to explore Chinese medicine syndrome differentiation and treatment of nocturnal enuresis in children. Materials and Methods: Based on a view of Chinese medicine and Western medicine periodicals, literatures and textbooks in the last decades related to children with nocturnal enuresis, we tried to discuss the treatment approaches to Nocturnal Enuresis in order to offer some reference for clinical treatment. Results: According to the literatures analysis and induction, the main TCM syndrome differentiation of Nocturnal Enuresis are deficiency of kidney qi, deficiency of spleen and lung qi, dampness and heat of liver and incoordination between heart and kidney. There are treatment of TCM prescription, massage therapy, acupuncture, and acupuncture with fumigation and so on. Conclusion: The treatment of deficiency of kidney qi are Tu-Si-Zi powder or Sang-Piao-Xiao powder plus Suo-Quan pill, and Chinese herbs mainly included Shu Di Huang, Aconite,Tu-Si-Zi, Bu-Gu-Zhi, Ootheca Mantidis. The treatment of deficiency of spleen and lung qi are Bu-Zhong-Yi-Qi-Tang plus Suo-Quan pill, and Chinese herbs mainly included Huang-Ch'i, Dangshen, Atractylodes macrocephala Koidz, Cimicifuga foetida, Fructus Alpiniae Oxyphyllae. The treatment of dampness and heat of liver are Long-Dan-Xie-Gan-Tang, and Chinese herbs mainly included Gentian, Bupleurum, Scutellaria baicalensis, Gardenia, Rehmanniae Radix. The treatment of incoordination between heart and kidney are Dao-Chyh-San plus Jiao-Tai-Wan, and Chinese herbs mainly included Sang-Piao-Xiao, Grassleaf sweetflag rhizome, Polygala, Poria cum radix pini, Angelica sinensis. The periods and syndromes of diagnosis and the corresponding prescription could be the prescription reference for clinicians. The pharmacological mechanisms of the prescriptions are still looking forward to further study.

並列關鍵字

Children with Nocturnal Enuresis ； Traditional Chinese Medicine dialectic

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兒童遺尿症之中醫辨證論治文獻探討

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