RESUMO
Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder among children. The theory of traditional Chinese medicine (TCM) does not have a special term of this disease, and classifies ADHD to the category of " forgetfulness" " dysphoria" " injudiciousness" according to its clinical manifestations. TCM theoretic and clinical systems for treating ADHD have been developed, but current pharmacodynamics studies of TCM on ADHD have mostly focused on neurotransmitter metabolic system and its receptor signaling pathway to reflect the advantages of multi-component and multi-target effect of TCM, but failed to demonstrate the scientific connotations of TCM theory, such as " coordination between kidney and brain" and " steady Yin and vexed Yang" , and ignored the delay in cortical maturation as the core neuropathology of ADHD. The symptoms relating to " restlessness of Yang" due to Yin deficiency that cannot inhibit hyperactivity of Yang, kidney-Yin deficiency and liver-Yang excess syndrome is the most common syndrome of ADHD, and TCMs with effect of invigorating kidney and filling sea of marrow are mostly used by TCM practitioners. According to anatomy basis of neuronal development disorder, the new theory of " energy metabolism dysfunction" , the pathogenesis hypothesis of sea of marrow development disorder and its relevant clinical practices and experimental studies, substantial basis studies of the therapy for " invigorating kidney and filling sea of marrow" , as well as pharmacodynamics study of <italic>Rehmannia glutinosa</italic> (Shudihuang) for treating ADHD, we put forward ADHD pathogenesis that " restlessness of Yang due to Yin deficiency" is related to the disorder of executive function due to the delay in cortical maturation, energy metabolism dysfunction and neurodevelopmental disorder, and regarded that TCMs with effect of invigorating kidney and filling sea of marrow are the most commonly used to treat ADHD, and improve delay in cortical maturation corresponding to sea of marrow insufficiency by regulating dysfunction of neurodevelopment and energy metabolism, so as to relieve the core symptoms of ADHD. The new treatment model of TCM with effect of invigorating kidney and filling sea of marrow for treating ADHD will provide a theoretical basis for improving the clinical efficacy of ADHD.
RESUMO
Objective To observe the effects of acupuncture at "Sanyinjiao" (SP6) and "Baihui" (GV20) on behaviors and contents of monoamine neurotransmitter dopamine (DA), noradrenalin (NE) and 5-hydroxytrypamine (5-HT) in prefrontal cortex (PFC) of attention deficit hyperactivity disorder (ADHD) rats; To discuss mechanism of action of acupuncture for prevention and treatment of ADHD. Methods 4-week-old SHR rats were randomly divided into the model group, Western medicine group and acupuncture group, and WKY rats with the same age were selected as the normal control group, with 10 rats in each group. Acupuncture was applied to "Sanyinjiao" (SP6) and "Baihui" (GV20) of rats in acupuncture group for 15 min. The rats in Western medicine group was given MPH (ritalin) for gavage, and rats were treated for 4 weeks in the dark-phase. Open field test (OFT), elevated plus maze (EPM) and novel object recognition test (NORT) were conducted to evaluate the spontaneous activity, impulsivity and learning-memorial ability of rats individually at the end of treatment. Contents of DA, NE and 5-HT in PFC were detected by HPLC. Results Compared with the normal control group, all of the behavior parameters of rats in model group were significantly higher (P＜0.05), and the contents of DA, NE and 5-HT in PFC of model group were lower than those of normal control group (P＜0.05). Compared with the model group, acupuncture group showed shorter movement distance, less rearing and fewer grooming activities in the OFT; percentages of times of entering the open arms and staying duration were reduced in the total period in the EPM; preference index in the NORT was elevated (P＜0.05); the contents of NE and 5-HT in PFC of acupuncture group increased significantly (P＜0.05). Conclusion Acupuncture at "Sanyinjiao" (SP6) and "Baihui" (GV20) canreduce the spontaneous activity and impulsivity, and improve learning and memory ability of ADHD model rats, which may be related to elevated contents of NE and 5-HT in the PFC.