Treating attention deficit hyperactivity disorder in children by "emphasizing lung regulation" based on the dynamic-static concept of ministerial fire

The theory of ministerial fire and its dynamic-static concept constitute vital components of traditional Chinese medicine. Guided by ZHU Danxi′s dynamic-static concept of ministerial fire, it is proposed that the core pathogenesis of attention deficit hyperactivity disorder (ADHD) in children lies in an imbalance between the dynamic and static states of ministerial fire. Within this framework, insufficiency of the yin-static aspect of ministerial fire represents as the root cause, and unrestrained hyperactivity represents as the manifestation. Ministerial fire is entrusted by the heart and regulated by the lung. The descending function of the lung serves as the foundation of the transformation source, which is essential for the interaction between monarch fire and ministerial fire, while simultaneously governing the static and descending properties of ministerial fire. The lung governs qi and houses the corporeal soul, which is responsible for tranquility and descending. When the corporeal soul is unsettled, the lung fails to regulate ministerial fire, leading to its failure to descend and a disturbance in its dynamic-static states, thereby playing a crucial role in the pathogenesis of ADHD. Consequently, the approach of syndrome differentiation and treatment of this disease by "prioritizing calming techniques and emphasizing lung regulation" is proposed. The root cause should be addressed with the modified combination of Shengmai Powder and Guizhi Jia Longgu Muli Decoction to regulate the lung and harmonize ying, and stabilize hyperactive ministerial fire. Secondary manifestations should be addressed with the modified combination of Xiebai Powder and Bentun Decoction to clear metal and restrain wood, and descend counterflow to calm the rush. This approach aims to strengthen the theoretical foundation for treating ADHD by focusing on the lung, thereby providing a theoretical reference for clinical diagnosis and management.