Professor Wang Sumei's Experience In Treating Children With ADHD (spleen Deficiency And Liver Hyperactivity Syndrome) And Case Series Researc

Objective:1.In this study,writer conducted data mining of clinical cases of children with hyperactivity due to spleen deficiency and liver hyperactivity by Professor Wang Sumei,analyzed and summarized Professor Wang Sumei’s experience in treating children with hyperactivity due to spleen deficiency and liver hyperactivity,and derived the core prescriptions.2.The core prescriptions derived from the data mining were clinically validated,and a case series study was conducted to observe the improvement of symptoms in children and objectively evaluate the clinical efficacy,with the aim of improving the treatment protocols of famous Chinese medicine practitioners and providing new ideas for the treatment of children with hyperactivity due to spleen deficiency and liver hyperactivity.Methods:1.The outpatient medical records of children with hyperactivity with spleen deficiency and liver hyperactivity evidence treated by Professor Wang Sumei from 2019 to 2022 were included,and screened according to the inclusion and exclusion criteria to obtain 109 eligible children with a total of 314 visits.The information of the child’s consultation was entered into the "Knowledge Management and Service Platform for the Inheritance of Experiences of Famous Doctors and Masters",and after standardized processing,frequency analysis and complex network analysis were used to discover medication patterns and core prescriptions,and combined with in-depth interviews,the treatment ideas of Professor Wang Sumei for children with hyperactivity due to spleen deficiency and liver hyperactivity were derived.2.By conducting a prospective case series study,children with hyperactivity with spleen deficiency and liver hyperactivity evidence who met the inclusion and exclusion criteria were recruited in the outpatient clinic for a data mining core prescription-based herbal treatment,and information on patients’ names,ages,and past histories were collected for a 2-month treatment period.The main observation indexes were SNAP-Ⅳ scale scores,TCM evidence score scale scores,and adverse reactions during medication administration.Data were collected,statistically analyzed,and the improvement of clinical symptoms by core prescriptions was observed and evaluated for efficacy.Results:1.Data mining1.1 Among the 109 children included in this study,there were 91 boys(83%)and 18 girls(17%),with a male-to-female ratio of about 5.1:1.The prevalence rate of boys was higher than that of girls,and the age was mostly concentrated in the age group of 7-11 years,accounting for about 74.32%of the total number,which was concentrated in the school age.1.2 The 109 children in this study had 210 symptoms,and the top 7 symptoms were inattention,irritability,hyperactivity,poor appetite,dry stools,delay in doing things,and difficulty in falling asleep.1.3 In this study,Professor Wang Sumei used a total of 208 Chinese medicines,and the commonly used Chinese medicines were Yanyizhiren,Shichangpu,Cuguijia,Mudanpi,Zhiyuanzhi,Gouteng,Baihe,Shenglonggu,Chenpi,J iangzhizi,Tianma,Beichaihu,Fabanxia,Shudihuang,Longdan,Huanglian,Baishao,Fuchaojiangc an,Fuling,C haojuemingzi.1.4 In treating children with hyperactivity due to spleen deficiency and liver hyperactivity,Professor Wang Sumei often uses deficiency tonics,heat-clearing agents,tranquilizers,and phlegm-relieving agents.1.5 There are 12 types of toxic Chinese medicines commonly used by Professor Wang Sumei in clinical practice,they are Heishunpian,Chaocangerzi,Qingbanxia,Yanjili,Quanxie,Chuanlianzi,Beidougen,Baiqucai,Zhi baifuzi,zhitiannanxing,Chaokuxingren,Zhiwuzhuyu.1.6 The statistics of four properties,five flavours and meridian:The Chinese medicine commonly used by Professor Wang Sumei to treat children with hyperactivity due to spleen deficiency and liver hyperactivity are cold,warm,or flat in nature,bitter,sweet,or pungent in taste,and most of them are attributed to the liver,heart,and kidney meridians.1.7 Professor Wang Sumei’s core prescription for treating hyperactive children with spleen deficiency and liver hyperactivity is tonics for warm the gall bladder and calm the mind which composed of Chen Pi,Fa Banxia,Bei Chaihu,Gou Teng,Jiang Zhizi,Long Dan,Fu Ling,Shi Changpu,Zhi Yuanzhi,Duan Longgu,Cu Guijia,Tian Ma,Zhu Ru,Dang Shen,Gan Cao.Commonly used clinical Chinese medicine combinations are Sang Shen-Jiu Nvzhenzi,Fu Ling-Huang Lian-Chao Juemingzi-Long Dan.2.Case series study2.1 A total of 30 children were included in this study,25 boys and 5 girls,with a male to female ratio of 5:1,a mean age of 7.87 ± 1.57(years)and a mean disease duration of 2.65 ±1.49(years).2.2 Comparison of SNAP-Ⅳ scale scores:After two months of treatment,there were statistically significant differences in the SNAP-Ⅳ scale items of inattentiveness,hyperactivity/impulsivity,and oppositional defiance compared with those before treatment(P<0.01),and the hyperactivity index was also significantly reduced compared with that before treatment(P<0.01).2.3 Comparison of the scores on the TCM syndrome scale:the scores on the scale of laxity,restlessness,changeable interests,small movements,emotional instability,hyperactivity,restlessness,agitation,loss of appetite,poor memory,insubstantial sleep and irregular bowel movements were significantly different from those before treatment(P<0.01).2.4 During the medication period,there were no adverse reactions observed in 30 children.Conclusions:1.Professor Wang Sumei treats children with hyperactivity due to spleen deficiency and liver hyperactivity,often using deficiency tonics,heat-clearing tonics,tranquilizers and phlegm-relieving Tonics.The Chinese medicine commonly used are cold,warm,or flat in nature,bitter,sweet,or pungent in taste,and most of them are attributed to the liver,heart,and kidney meridians.In clinical treatment,some toxic substances are also added as appropriate,the core prescription is tonics for warming the gall bladder and calming the mind.2.Tonics for warm the gall bladder and calm the mind can improve the clinical symptoms of children with ADHD with spleen deficiency and liver hyperactivity to a certain extent,and there are no significant adverse effects while taking it,which makes it a safe and effective treatment.