The liver is the organ of wind and wood, and its sound is the call, and its change is the grip. The “Nei Jing” says that “all winds and dizziness belong to the liver”, and all twitching in any part of the body is called “wind” in Chinese medicine. “Wind is a Yang evil, and its nature is good at moving and changing”, so the clinical symptoms of multiple twitching disorder may be relieved or disappear from time to time, but they are prone to recurrence or new twitching symptoms. The wind is light in nature, and the wind is the only thing that can reach the top of the mountain, so various twitching symptoms of the head and face are common. Wind is an important factor in the development of tic disorders, but there are also cases where the external wind leads to the internal wind, for example, children with multiple tic disorders often have recurrent or aggravated tic symptoms due to external wind. Therefore, this disease is most closely related to the liver, and the basic pathological feature of this disease is the internal movement of liver wind. The liver collects blood and is the master of the tendons, using yin and yang. Insufficient liver blood, yin does not treat yang, blood does not nourish tendons, resulting in internal movement of liver wind, resulting in tendon constriction, trembling, S, etc. Therefore, blood deficiency generates wind as the main pathogenesis of this disease. 2. Nourishing the blood and quenching the wind to treat tics Li Zhongzhi’s “Essential Readings in Medicine? This important rule of Chinese medicine was established for the treatment of paralysis, but it has been extensively applied to the evidence of blood deficiency and wind. The so-called “treatment of blood” is to nourish blood and regulate the liver, so that liver blood is sufficient, Yin can cure Yang, blood can nourish tendons, then the convulsions stop. With sufficient Qi and Blood, the body is strong and healthy, internal wind cannot be generated and external wind cannot be invaded, so the wind will be extinguished. Professor Hu Tiancheng, our mentor, believes that pediatric multiple twitching disorder is an internal movement of liver wind, and that “all winds and dizziness belong to the liver”. According to the principle of “treating the wind first by treating the blood, the wind will be extinguished when the blood is flowing”, we propose to treat the disease from the blood, and use Siwu Tang (Sifu Tang) combined with Spasm Stopping Powder to nourish the blood and activate the blood to quench the wind and stop the spasm. Siwu Tang (Taiping Huimin Hodong Bureau Formula) is a basic formula for tonifying and regulating Blood, and is known as “the general formula for all Blood diseases”. In this formula, Radix Rehmanniae is sweet, warm, thick in taste and soft in texture, long in nourishing Yin and nourishing Blood, and is the ruling herb; Radix Angelicae Sinensis is sweet, pungent and warm, nourishing Blood, nourishing Liver and invigorating Blood, and is the subordinate herb. The combination of the Yin and softness of Radix Paeoniae and the pungent and warm Radix Angelicae Ligusticum nourishes the Blood without stagnating it, and nourishes it without harming it. The combination of the four herbs nourishes the Blood and invigorates the Blood, thus harmonizing the Ying and Blood. Therefore, it can be used for Blood deficiency to tonify Blood and for Blood stasis to promote Blood circulation, and is therefore a general formula for all Blood diseases. Stopping Spasm (Compiled by Shanghai College of Traditional Chinese Medicine, “Formulary”) is composed of two herbs, namely, Whole Scorpion and Centipede, which are pungent, flat and poisonous, and belong to the liver meridian, and have the function of quenching wind and stopping spasm and relieving pain. Centipede is pungent, warm and poisonous, and belongs to the liver meridian. It is good at moving around and reaching inside and outside, and is an important medicine to quench wind and stop spasm. The combination of the two prescriptions can help nourish the blood and regulate the liver to treat the root of the problem, and stop spasm to quench the wind and stop spasm to treat the symptoms of the problem. 3. Typical case He, male, 7 and a half years old, was seen on March 25, 2005. He has been squeezing his eyebrows and tilting his neck for more than 1 year. At the beginning of the case, the child squeezed his eyebrows and fidgeted with his eyes, but the parents thought it was because the child was naughty and did not pay attention to it. At the time of the consultation, the child was tilting his neck, grinning, blinking, and making unconscious vocalizations in his throat, with a red throat, light red color, thin white fur, and thin pulse. The diagnosis was multiple twitching disorder with blood deficiency and wind movement. The treatment is to nourish Blood and invigorate Blood, quench wind and stop spasm. 7 doses, 1 dose per day with water. Second diagnosis: the child’s grin, blinking, laryngeal vocalization significantly reduced, did not appear again tilted neck, but frequent throat clearing, like cold drinks, red throat, light red color, thin yellow moss, thin pulse. Guarding the above plus 10g of Mab, 10g of Sargent. Clear heat and throat, and then into 7 doses. Third diagnosis: the child occasionally blinked, the remaining symptoms disappeared. The formula used to tonify the liver with liver tonic soup plus flavor to nourish blood and soften the liver, medicine: 15g of raw earth, 15g of white peony, 10g of angelica, 10g of fried Chuanxiong, 10g of jujube, 10g of papaya, 10g of chrysanthemum, 10g of Xia Ku Cao. 7 doses to consolidate the therapeutic effect. Liver Tonic Soup is composed of Si Wu Tang with jujube, papaya and roasted licorice. In this formula, Siwu Tang nourishes Yin and Blood; sour jujube seeds, papaya and licorice sour and sweet transform Yin, soften the Liver and soothe the tendons. 4.Experience The clinical characteristics of multiple twitching disorder are rapid and repeated irregular twitching of expression muscles, neck muscles or limb muscles, often accompanied by compulsive, impulsive and hyperactive symptoms. According to the Nei Jing, “wind is moving when it is victorious” and “wind is a yang evil, its nature is good at moving and changing”, so the symptoms of this disease, such as squeezing eyebrows, blinking eyes, grinning, shrugging nose, tilting neck, twisting shoulders, kicking legs, stamping feet, etc., can be summarized as “wind The “wind” image. Following the theory of “treating wind first treats blood, the wind will be extinguished when the blood is flowing”, we treat the disease from blood, applying Siwu Tang with the addition of Stop Spasm San to nourish the blood, quench the wind and stop spasm, and adding and subtracting according to the evidence, the treatment of pediatric hyperactivity is effective, and the recurrence rate is low. The basic formula is: Shu Di Huang 15g (or Sheng Di Huang for those with deficiency heat), Bai Shao 10g, Angelica Sinensis 10g, Chuan Xiong 10g, Quan Scorpion 10g, and Centipede 1. Add and subtract: for facial twitching such as blinking, frowning, snorting, grinning, etc., add Chrysanthemum, Bupleurum, Cicada, Cang Er Zi; for head and neck twitching such as head shaking, neck twisting, shoulder shrugging, etc., add Ge Gen, Tian Ma, Hooked Vine; for trunk twitching such as chest lifting, waist twisting, abdomen bulging, buttocks pouting, etc., add Citrus Aurantium, White Peony, Radix Platycodon; for limb twitching such as hand flinging, arm raising, leg kicking, foot stomping, etc., add Mulberry, Papaya, Stretching Herb. For those with anxiety and depression, add Radix et Rhizoma Glycyrrhiza Glabra, Fructus Macrocephalae and Fructus Jujubae; for those with impatience and irritability, add Radix et Rhizoma Chai Hu, Rhizoma Huang Lian, Gardenia jasminoides and Mother of Pearl. In addition, although multiple tics are caused by “internal movement of liver wind”, the evidence belongs to “internal wind”, but there are “external wind” leading to “internal wind”. “Therefore, it is common for children with hyperactivity to have recurrent or aggravated twitching symptoms due to colds. If the child has only mild cold symptoms, such as nasal congestion, runny nose, light cough, etc., and no obvious fever, the basic formula can be supplemented with thorny mustard, windbreak, Su Ye, and Cang Er Zi to relieve the wind and relieve the symptoms; if the cough is obvious and accompanied by fever, then the formula should be referred to “cold” and “cough”. If the cough is obvious and accompanied by fever, we should refer to “cold” and “cough” for evidence-based treatment and wait until the external sensation is relieved before treating this disease.