注意力缺失過動症的中西醫觀點與相關實證研究進展

The overview of Attention Deficit Hyperactivity Disorder in Chinese medicine and conventional medicine and its evident base studies

注意力缺失過動症（Attention Deficit Hyperactivity Disorder）是一個學齡兒童常見的心智疾病，根據臨床表現可歸於中醫「風證」、「煩躁」、「健忘」等範疇。在學齡兒童約佔 8% ~ 10%。目前尚未確定直接的致病原因，但研究發現與兒茶酚胺代謝的基因突變或遺傳、環境因素有關。根據臨床症狀表現分為多動/衝動型或注意力不集中型，西醫治療以中樞神經興奮劑與三環類抗憂鬱藥為主。中醫病位以心、肝、脾、腎四臟為主，主要病機與先天不足、後天失養導致髓海不足，竅道不暢；或肝腎陰虛，君相火旺，虛陽亢動有關；或者心脾氣血兩虛，心神失養；或過食肥甘厚味、痰熱內擾心神為主，可分為腎虛肝亢，心脾不足，痰熱擾心等證型，治法以填補腎精腎氣，滋腎平肝為主， 配以安神定志或清熱化痰等方式治療。除此之外，同時介紹目前關於注意力缺失過動症的中醫藥相關實證研究，除了中藥內服藥外，更有針灸等方式治療。整體而言，以上方式均對注意力缺失過動症治療有幫助，並且可避免長期服用西藥對兒童所產生的副作用。

Attention Deficit Hyperactivity Disorder (ADHD) is one of common psychiatrist disorders of school age children. According to clinical presentations ADHD can goes to the syndromes as following: winds, agitation, forgetfulness, etc. The prevalence of ADHD is about 8 to 10 percent in school age children. The etiology of ADHD still unclear, but according to previous studies may had relationship with genomic defect of serotonin metabolism, hereditary or environments factors. ADHD can divide into hyperactive/impulse type or inattention type. The treatment in conventional medicine mainly used central nervous stimulator and tricyclic antidepressants. The locations of diseases in Chinese medicine are heart, liver spleen and kidney. Mechanisms of disease are deficiency of innate essence and acquired essence, which causes deficiency of sea of marrow and clouding of orifice of sense organ; liver-kidney yin deficiency lead to abnormal exuberance ministerial fire; or deficiency of the heart-spleen qi and blood cause malnutrition of heart spirit, and phlegm-fire harasses the heart. The syndromes of ADHD divided into kidney deficiency with ascendant hyperactivity of liver yang and heart-spleen deficiency. The therapeutic principles are tonifying the kidney yin and yang, pacifying the liver to subdue yang, tranquilizing, clearing heat and resolving phlegm. Meanwhile, we review the evidence base studies of ADHD in Chinese medicine, included Chinese herb and acupuncture. The Chinese medicine has benefit for ADHD treatment and may help to avoid side effect related to conventional medication.