基于“阳气者,精则养神,柔则养筋”理论论治纤维肌痛综合征思路  

Treating fibromyalgia syndrome thinking based on the theroy of‘as for the yang qi,if it is firm,it nourishes spirit,if it is soft,it nourishes sinew’

作　　者：杜芸 徐江喜 王丹[1,2] 朱跃兰[2] DU Yun;XU Jiang-xi;WANG Dan;ZHU Yue-lan(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中华中医药杂志》2022年第6期3312-3315,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市丰台区临床重点专科(风湿科)项目。

摘　　要：纤维肌痛综合征(FMS)是以周身弥漫性疼痛及睡眠障碍、疲劳、精神障碍等为核心症状群的身心疾病,多归于中医周痹、筋痹、气痹、郁证等范畴。“阳气者,精则养神,柔则养筋”出自《素问·生气通天论》,高度概括了阳气具有神、筋共养的作用。基于阳气濡养筋、神的生理功能,结合FMS痹痛与神志异常并发的临床特点,从外邪易侵人体致不通则痛与筋失濡养致不荣则痛两方面,论述阳气不足致筋骨关节疼痛;从阳气亏虚致五脏功能异常进而神失所养论述FMS患者疲劳乏力、情志异常等非疼痛症状。治疗方面以温补阳气为主,内治以补肾助阳为核心,外治以温通督脉为关键,内外同治提高临床疗效,改善患者生活质量。Fibromyalgia syndrome(FMS)is a physical and mental disease that is characterized by chronic widespread pain,sleep disorder,fatigue,and many other symptoms that impair the quality of life.It mostly belongs to the category of general arthralgia sinew impediment,qi impediment and depression syndrome in Chinese Medicine.‘As for the yang qi,if it is firm,it nourishes spirit;if it is soft,it nourishes sinew’,is from the Suwen·Shengqi Tongtian Lun,which summarized the role of yang qi in the cultivation of spirit and sinew.Based on the physiological function of yang qi and the clinical characteristics of fibromyalgia syndrome,this paper has discussed the deficiency of yang qi causes FMS.Both obstruction and under-nutrition of sinew lead to pain.When spirit losing nutrition,mental disorders and other non-pain symptoms appear.So warming yang qi is the main treatment.Tonifying the kidney yang is the core of internal treatment.Warming and unblocking the governor vessel is the key to external treatment.The combination of internal and external treatment can improve the clinical efficacy and the quality of life of patients.

关 键 词：纤维肌痛综合征 阳气 黄帝内经 内外同治 督脉 思路 痹痛 神志异常 

分 类 号：R259[医药卫生—中西医结合]