中医杂志

基于《黄帝内经》中五脏藏神理论，认为五脏藏神功能失常是儿童遗尿症的关键病机，并提出以五脏调神为治则治法。心气不足、心神失藏、膀胱气化失常者治宜调心神，方用归脾汤加减；肺失宣降、肺魄不藏、水液妄行者治宜定肺魄，方用玉屏风散合菖蒲郁金丸加减；脾虚失运、脾意不藏、统摄水液无权者治宜养脾意，方用补中益气汤合菟丝子散加减；肝失疏泄、肝魂妄动、水渍横行者治宜安肝魂，方用龙胆泻肝汤佐入解郁安神之品；肾气亏虚、肾志不充、约束膀胱无力者治宜充肾志，方用自拟遗尿方加减。同时治疗全程配伍醒脑开窍之品以辅助调神。

Based on the theory of "five zang organs storing spirit" in The Inner Canon of Yellow Emperor （《黄帝内经》）, it is believed that the dysfunction of the five zang organs in storing spirit is the key pathogenesis of enuresis in children, and thus the therapeutic principle and method of "regulating spirit through the five zang organs" are proposed. For patients with heart qi insufficiency, heart spirit failing to store, dysfunction of bladder qi transformation, the treatment should focus on regulating heart spirit, with modified Guipi Decoction （归脾汤） as the recommended prescription; for patients with lung failing to disperse or descend, corporeal soul of lungs failing to store, and unregulated flow of body fluids, the treatment should emphasize calming lung corporeal soul, using modified Yupingfeng Powder （玉屏风散） plus Changpu Yujin Pill （菖蒲郁金丸）； for patients with spleen deficiency leading to dysfunction in transportation and transformation, failure of the spleen to store idea(one of the five spirits corresponding to the spleen), and inability to govern and regulate body fluids, the treatment should nourish spleen idea, adopting modified Buzhong Yiqi Decoction （补中益气汤） plus Tusizi Powder （菟丝子散）； for patients with liver failure in dredging and dispersing, reckless stirring of liver soul(one of the five spirits corresponding to the liver), and abnormal accumulation and overflow of water-dampness, the treatment should focus on calming liver soul, using Longdan Xiegan Decoction （龙胆泻肝汤） supplemented with herbs resolving depression and calming the spirit; for patients with kidney qi deficiency, insufficient kidney will(one of the five spirits corresponding to the kidney), and weakness in controlling the bladder, the treatment should replenish kidney will, using the modified self-prescribed Yiniao Decoction （遗尿方）. Meanwhile, throughout the entire treatment process, herbs that awaken the mind and open the orifices are combined to assist in regulating the spirit.