{"id":9229,"date":"2024-06-06T01:51:58","date_gmt":"2024-06-06T01:51:58","guid":{"rendered":"https:\/\/tcmdrma.com\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%84%bf%e7%ab%a5%e6%8a%bd%e5%8a%a8%e7%a7%bd%e8%af%ad%e7%bb%bc%e5%90%88%e5%be%81%e4%b8%80%e4%be%8b\/"},"modified":"2025-05-09T10:33:41","modified_gmt":"2025-05-09T00:33:41","slug":"%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%84%bf%e7%ab%a5%e6%8a%bd%e5%8a%a8%e7%a7%bd%e8%af%ad%e7%bb%bc%e5%90%88%e5%be%81%e4%b8%80%e4%be%8b","status":"publish","type":"post","link":"https:\/\/tcmdrma.com\/zh-hans\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%84%bf%e7%ab%a5%e6%8a%bd%e5%8a%a8%e7%a7%bd%e8%af%ad%e7%bb%bc%e5%90%88%e5%be%81%e4%b8%80%e4%be%8b\/","title":{"rendered":"\u3010\u533b\u6848\u3011\u4e2d\u836f\u6cbb\u7597\u513f\u7ae5\u62bd\u52a8\u79fd\u8bed\u7efc\u5408\u5f81\u4e00\u4f8b"},"content":{"rendered":"

患儿，男，4岁半，主诉的西医病名为儿童抽动秽语综合征，具体表现为：眨眼睛，清嗓子，咧嘴，发出哼哼声，偶尔不由自主地口出秽言。病情在这些表现中交替发生。发病主要从MIQ隔离开始，至今三月余。之前看过两个中医大夫，都是刚开始吃立刻管用，但再吃就无效了。曾服用小柴胡汤，逍遥丸等。其他症状表现还包括，脾气急，话多，喜欢操心，汗出多，挑食，大便时干时稀，小便微偏黄，不易入睡，怕光等。每天都说肚子疼。手部皮肤看着发脏。脸色偏灰黄，不润。鼻塞。舌淡薄润，舌面气郁点，舌根处偏厚伴红点。脉浮细弦，下按无力。此为脾虚不涵木同时表不解，中药调理一段时间后症状明显减轻，治疗中患儿出现一次感冒，这是解表的重要契机，把感冒顺势治好后，症状随之基本消失，患者未再治疗，3个月左右再回访，情况稳定，仅偶尔间或眨眼一两次。<\/p>\n

就这个医案，我们讨论几点：<\/p>\n

其一，为什么之前大夫开的药，开始用有效，之后就不管用了呢？我们一般把抽动理解为肝风内动的表现，或者按照六经辩证从少阳入手。但是儿童肝常有余而脾不足，如果脾土不足，则无法涵木。这就像在松软的土地上种的小树苗，风一吹就会动。所以，治疗中培补脾土，是治疗的关键因素之一。不能简单地把性子急理解为肝旺而用小柴胡汤。<\/p>\n

其二，为什么感冒是其中重要的治疗契机呢？在把患者的体质补足之后，他的身体需要一个契机来解表。一场感冒往往有种触发整个太阳经表系统重置的效应，所以，在原来治疗的基础上，当感冒来的时候，顺势而为，把太阳中风象也解开了。这也是我很多次不厌其烦地说很多病的治疗要重视感冒契机的原因<\/strong>。<\/p>\n

 <\/p>\n

 <\/p>\n

注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。<\/p>\n

\n

医案编号：075<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

患儿，男，4岁半，主 […]<\/p>\n","protected":false},"author":1,"featured_media":9230,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[76],"tags":[],"class_list":["post-9229","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-76"],"acf":[],"uagb_featured_image_src":{"full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",928,628,false],"thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-150x150.jpg",150,150,true],"medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-300x203.jpg",300,203,true],"medium_large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-768x520.jpg",768,520,true],"large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",928,628,false],"1536x1536":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",928,628,false],"2048x2048":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",928,628,false],"blog-large":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-669x453.jpg",402,272,true],"blog-medium":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-320x217.jpg",298,202,true],"recent-posts":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-700x474.jpg",651,441,true],"recent-works-thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-66x45.jpg",66,45,true],"fusion-200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-200x135.jpg",200,135,true],"fusion-400":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-400x271.jpg",400,271,true],"fusion-600":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-600x406.jpg",600,406,true],"fusion-800":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-800x541.jpg",800,541,true],"fusion-1200":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",928,628,false],"portfolio-full":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome.jpg",591,400,false],"portfolio-one":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-540x365.jpg",402,272,true],"portfolio-two":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-460x311.jpg",436,295,true],"portfolio-three":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-300x203.jpg",300,203,true],"portfolio-five":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-177x120.jpg",177,120,true],"woocommerce_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-500x338.jpg",500,338,true],"woocommerce_single":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-700x474.jpg",700,474,true],"woocommerce_gallery_thumbnail":["https:\/\/tcmdrma.com\/wp-content\/uploads\/2024\/06\/tourette-syndrome-100x100.jpg",100,100,true]},"uagb_author_info":{"display_name":"Max Ma","author_link":"https:\/\/tcmdrma.com\/zh-hans\/author\/tcmdrma-com\/"},"uagb_comment_info":0,"uagb_excerpt":"患儿，男，4岁ࡔ…","_links":{"self":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9229","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/comments?post=9229"}],"version-history":[{"count":1,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9229\/revisions"}],"predecessor-version":[{"id":13863,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/posts\/9229\/revisions\/13863"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media\/9230"}],"wp:attachment":[{"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/media?parent=9229"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/categories?post=9229"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tcmdrma.com\/zh-hans\/wp-json\/wp\/v2\/tags?post=9229"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}