基于"木郁达之,土郁夺之"论治儿童性早熟合并肥胖OA

The onset of precocious puberty(PP)complicated with obesity in children is closely associated with"liver stagnation trans-forming into fire with frenetic stirring of ministerial fire"and"spleen deficiency with exuberant dampness and internal obstruction of phlegm-turbidity,"which further triggers the pathological progression of"stagnated wood restraining earth and congested earth counter-restraining wood."Therefore,the liver and spleen should be regarded as the core in clinical treatment of this disease so as to restore the physiological functions of"the liver governing free flow of qi"and"the spleen governing transportation and transformation."For the syn-drome of liver stagnation transforming into fire and frenetic stirring of ministerial fire,the principle of"releasing stagnated wood"should be followed.Therapies of soothing the liver and relieving stagnation,purging fire and nourishing yin are adopted to smooth liver qi,clear stagnant fire,replenish yin fluid and restrain ministerial fire to its proper position,with Modified Free Wanderer Powder as the applica-ble formula.For the syndrome of spleen deficiency with exuberant dampness and internal obstruction of phlegm-turbidity,treatment should be guided by the theory of"removing stagnated earth,"and the therapeutic principles are to invigorate the spleen and resolve dampness,eliminate phlegm and unblock collaterals.Invigorating spleen qi can cut off the source of generating phlegm,and dispersing and eliminating damp-turbidity can obstruct stasis,ultimately guiding tiangui to its normal chronological rhythm,with Modified Two Ma-tured Substances Decoction adopted.For the syndrome of stagnated wood restraining earth and congested earth counter-restraining wood,simultaneous regulation of the liver and spleen and combined application of elimination and tonification are required.On the one hand,medicinals that soothe the liver and regulate qi are used to restore the function of"the liver governing free flow of qi",so that smooth qi movement resolves phlegm and promotes unobstructed blood circulation.On the other hand,spleen-invigorating and qi-replenishing me-dicinals can enhance the function of the spleen governing transportation and transformation to dredge the generation source of phlegm,so Modified Free Wanderer Powder can be prescribed.