注意力缺陷多动障碍（ADHD）是儿童期最常见的精神障碍之一，目前临床治疗存在疗程长、易复发、难治愈等问题。本研究基于中医理论“阴平阳秘，精神乃治”，认为“阳动有余、阴静不足、阴虚阳亢，气阴两虚”是该病的核心病机，临床采用益气养阴宁心法疗效确切。既往研究认为“脑内多巴胺(DA)功能缺陷”是ADHD发病的主要机制,但近年来国内外文献报道，ADHD的病理机制可能存在多巴胺(DA)、去甲肾上腺素(NE)、和5-羟色胺(5-HT)三种神经递质平衡的失调。因此，本研究提出静宁方参与调节单胺类神经递质DA、NE、5-HT含量及其代谢产物的变化而发挥治疗作用的假说。采用高效液相色谱法（HPLC）检测SHR模型大鼠纹状体内DA、NE、5-HT及其代谢产物DOPAC 、HVA、5-HTAA含量，免疫组化检测DAT的表达水平；旨在从多系统、多靶点探讨静宁方治疗多动症的作用靶点，进一步揭示中药治疗ADHD的作用机制和科学内涵，为临床推广应用提供理论依据。

Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders in childhood. This disease is needed long period treatment. It is difficult to cure and easy to relapse. The study is based on the theory of "yin-yang balance, spirit being healing" in traditional Chinese medicine. The core of the disease pathogenesis is imbalance of Yin and Yang. Yang is more active, Yin is less static, leading to Qi and Yin deficiency". The therapy principle is nourishing Qi and Yin and calming nerves. In a previous study it was thought that "defects" in brain dopamine (DA) function is a major mechanism of the pathogenesis of ADHD. But in recent years at home and abroad it have been reported in the literature, that ADHD may also be existed imbalance of DA、NE and 5-HT in pathophysiology. Therefore, we assumed that JingNing Formula play a role in the treatment of regulation of expression of DA, NE and 5-HT and their metabolites. The content of DA, NE、5-HT and their metabolites DOPAC 、HVA、5-HTAA will tested by HPLC, furthermore the methods of immunohistochemistry will be used to test the level of DAT. This study is aimed at exploring the targets for JingNing Formula in the treatment of ADHD from aspects of multi systems, multi-targets, and revealing the mechanism and the scientific connotation of traditional Chinese medicine in the treatment of ADHD, providing theoretical basis for clinical application.

注意力缺陷多动障碍（ADHD）是儿童期最常见的精神障碍之一，目前临床治疗存在疗程长、易复发、难治愈等问题。本研究基于中医理论“阴平阳秘，精神乃治”，认为“阳动有余、阴静不足、阴虚阳亢，气阴两虚”是该病的核心病机，临床采用益气养阴宁心法疗效确切。多巴胺系统功能的异常及相关转运体表达失衡可能是本病主要病机，本研究提出静宁颗粒参与调节CSTC回路中单胺类神经递质含量及DAT表达的变化而发挥治疗作用的假说。采用Morris水迷宫检测注意缺陷多动障碍（ADHD）模型动物-幼年自发性高血压大鼠（SHR）学习记忆能力；高效液相色谱法（HPLC）检测SHR模型大鼠纹状体内单胺类神经递质含量；Real-time PCR法检测各组大鼠纹状体多巴胺转运体（DAT）mRNA表达水平。结果显示：静宁颗粒既可以影响SHR大鼠逃避潜伏期及游泳距离，又可以影响撤台后大鼠在目标象限停留时间和穿越平台次数，因此可以使SHR大鼠空间学习记忆能力得到改善，但与临床一线阳性药物择思达相比，静宁颗粒对记忆能力的改善稍次。静宁颗粒能够提高大鼠脑纹状体中 DA、NE、5-HT含量，降低纹状体和前额叶中DAT mRNA表达水平，表明静宁颗粒与西药专注达一样，能够下调SHR大鼠额叶-纹状体回路中 DAT mRNA表达水平，减少突触前神经元对DA的重摄取，增加突触间隙的DA浓度，改善了中枢DA的神经信号传导功能，从而起到对ADHD的治疗作用。另一方面，也提示了DA、NE、5-HT含量的增高以及单胺类神经递质的协调平衡可能是ADHD发病的神经生化机制。鉴于神经生化功能机制的复杂性，以及中医复方制剂的多重作用，静宁颗粒治疗ADHD的有关作用机制，还有待进一步深入研究。