林晓红　温晓莹　陈秀梅

【摘要】总结罗笑容名老中医从肝脾两脏辨治配合小儿推拿手法治疗小儿多发性抽动症的临床经验。罗笑容教授认为抽动症发病根本与五脏失调相关，其中以肝为核心，与脾关系最为密切，标为风痰。辨证考虑脾虚肝旺、风痰内扰，治以疏肝健脾、化痰熄风为法，方用四逆散、四君子汤合温胆汤，配合抑木扶土小儿推拿手法，内服外治以调和阴阳，可明显缓解患儿抽动症状，取得良好的疗效。

【关键词】脾虚肝旺;抑木扶土;小儿推拿;多发性抽动症;罗笑容

【中图分类号】R249.2/.7 【文献标志码】 A【文章编号】1007-8517（2021）23-0081-04

Professor Luo Xiaorong's Clinical Experience in Treating Infantile

Tics from Liver and Spleen Combined with Manipulation

LIN Xiaohong^1，2WEN Xiaoying^1，2CHEN Xiumei^1，2*

1. Luo Xiaorong Renowed Doctor's Studio of Guangdong Provincial Hospital

of traditional Chinese medicine， Guangdong Province， Guangzhou 510120， China;

2.The Second Affiliated Hospital of Guangzhou University of traditional Chinese

medicine， Guangdong Province， Guangzhou 510120， China

Abstract：Summarize the clinical experience of Luo Xiaorong， a well-known veteran TCM doctor， in treating children with Tourette syndrome through differentiating treatment from liver and spleen combined with manipulation in children. Professor Luo believes that the onset of tics is fundamentally related to the imbalance of the five internal organs， which liver is the core， closest to the spleen， which manifestation is wind and phlegm.She considers syndrome differentiation is spleen deficiency and liver prosperity， wind and phlegm attacking internally，which is treated by soothing the liver and strengthening the spleen， eliminating phlegm and extinguishing wind. The prescription can use Sini Powder， Sijunzi Decoction and Gallbladder-Warming Decoction，combined with manipulation in children to restrain the wood and support the earth，using internal and external treatment at the same time to harmonize Yin and Yang， which can significantly relieve the children's tic symptoms， achieving good therapeutic effect.

Key words：Spleen Deficiency and Liver Prosperity; Restrain the Wood and Support the Earth; Manipulation in Children; Tourette Syndrome;Luo Xiaorong

羅笑容教授，生于中医世家，祖辈几代行医，在岭南享有盛誉。罗笑容教授幼承庭训，投身中医，对中医儿科有很独到的见解，从事儿科临床医、教、研工作60多年，现为广东省中医院主任医师，主任导师，儿科学术带头人，1993年被广东省人民政府授予“省名中医”称号，为第三批全国老中医药专家学术经验继承指导老师。笔者有幸侍诊于旁，受益良多，其治疗小儿常见病多发病有着丰富的经验，现将其从肝脾论治配合小儿推拿治疗儿童抽动障碍的经验介绍如下。

小儿多发性抽动症（ Multiple tics，MT） 又称为Tourette 综合征或抽动-秽语综合征（ Tourette syndrome，TS），起病于儿童和青少年时期，是一种常见的复杂的神经精神障碍性疾病。发病以男性多见，常在4～12岁起病，少数患儿至青春期后可自行缓解，部分延续至成人。其临床特征为不自主、突发、快速反复的肌肉抽动，抽动涉及1个或多个部位，如眨眼、斜视、皱鼻、噘嘴、努嘴、摇头、缩颈、耸肩、甩臂、伸臂、腹肌抽动、扭动肢体等。……