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小兒夜啼是小兒常見的一種病症，是指小兒白天能安靜入睡，但不明原因的入夜啼哭不安，時哭時止，或每夜定時啼哭，甚則通宵達旦(1,2)。本病多見於新生兒及六個月內的嬰兒，偶爾可見到較年長（如三到五歲）的患兒。嬰幼兒常以啼哭表達要求或痛苦，饑餓、驚恐、尿布潮濕、過冷或過熱、衣帶過緊、皮膚搔癢等均可引起啼哭，此時若喂以乳食、安撫、更換潮濕尿布、調整衣被厚薄後，啼哭可很快停止，不屬病態。
中醫根據臨床症狀，將小兒夜啼分為五個主要常見證型，分別為「脾經虛寒」、「傷食積滯」、「心肝積熱」、「心肝血虛」、「驚恐傷神」，臨床上依據不同證型進行治療(3-6)。同時也應詳細詢問病史，仔細進行理學檢查，必要時轉診西醫小兒科安排進一步檢查，以排除嬰幼兒因各種疾病（如中樞神經系統感染、顱內出血、癲癇、腸胃道急性感染或消化不良、脫水、腸套疊、腸阻塞、疝氣、感冒、流感、皰疹性咽峽炎、中耳炎、皮膚感染、發熱、外傷等）所造成的病理性啼哭，以免貽誤患兒病情。
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Night cry is a common pediatric sleep disorder in children. Our case is a 2-year-5-month-old girl presented with night cry and atopic dermatitis. “Spleen is often insufficient in children”, and dietary irregularities will cause a weakening of the spleen’s movement and transformation function, causing food stopped in middle-jiao, gas blocked, fire made and spirit perplexed based on the theory of “ Disorder of the stomach leading to insomnia with restlessness. ”
The common syndromes of Pediatric Night Cry include “cold and gas stopped spleen”, “accumulated heat in heart”, “milk stagnant and frightened spirit”. The treatment includes “warming spleen to disperse cold”, “clearing heart to relieve restlessness”, “invigorating spleen to regulate stomach”, “arresting convulsion to stop crying”, “treatment from the liver pathogenesis”, “treatment from the
gallbladder pathogenesis.”
【Keywords】Night Crying, Itching, Chinese Medicine
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99.8 中醫治療小兒夜啼
