中医药临床优势病种探讨——纤维肌痛综合征  

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine:Fibromyalgia Syndrome

作　　者：焦娟[1] 唐今扬[2] 侯秀娟[3] 李梦涛[4] 梁东风[5] 王玉华[6] 靖卫霞 李光韬[8] 张秦[9] 张永锋[10] 李光宇[11] 王钱[12] 杨扬 霍金[13] 莫美 郭继华 张霄潇[14] 姜泉[1] JIAO Juan;TANG Jinyang;HOU Xiujuan;LI Mengtao;LIANG Dongfeng;WANG Yuhua;JING Weixia;LI Guangtao;ZHANG Qin;ZHANG Yongfeng;LI Guangyu;WANG Qian;YANG Yang;HUO Jin;MO Mei;GUO Jihua;ZHANG Xiaoxiao;JIANG Quan(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Peking Union Medical College Hospital,China Academy of Medical Sciences,Beijing 100730,China;Chinese PLA General Hospital,Beijing 100853,China;Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Peking University First Hospital,Beijing 100034,China;Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Hospital,Beijing 100730,China;Institute of Acupuncture and Moxibustion,China,Academy of Chinese Medical Sciences,Beijing 100700,China;China Association of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院西苑医院,北京100091 [3]北京中医药大学东方医院,北京100078 [4]中国医学科学院北京协和医院,北京100730 [5]中国人民解放军总医院,北京100853 [6]首都医科大学附属北京世纪坛医院,北京100038 [7]北京中医药大学第三附属医院,北京100029 [8]北京大学第一医院,北京100034 [9]首都医科大学附属北京中医医院,北京100010 [10]首都医科大学附属北京朝阳医院,北京100020 [11]中国中医科学院望京医院,北京100102 [12]北京医院,北京100730 [13]中国中医科学院针灸研究所,北京100700 [14]中华中医药学会,北京100029

出　　处：《中国实验方剂学杂志》2024年第1期216-222,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院科技创新工程项目(CI2021A01505)。

摘　　要：纤维肌痛综合征(FMS)是一种以全身弥漫性疼痛为主要特征的难治性、慢性非关节性风湿病,目前尚无满意的治疗药物和治疗方案。中医药治疗方法众多,部分特色非药物疗法,如针刺、太极拳、八段锦等已显示出较为满意的疗效和安全性,具有明确的“身心同调”治疗优势和特点,2018年被国家中医药管理局纳入中医优势病种。为了明确FMS领域的研究进展和中医/中西医结合临床优势,中华中医药学会组织中西医风湿专业、心理专业、针灸脑病专业及产业等近20名专家围绕“FMS临床诊疗难点和中西医优势”进行了研讨,就FMS早期诊断的难点和应对、常见非特异症状的改善与维持、优选镇痛疗法、中医基本病机和治疗优势、中西医结合治疗方向等焦点问题形成以下建议。FMS目前面临早期正确诊断率低、患者参与度差、单纯西医治疗获益不理想这三重困境,为解决以上问题,该文建议以风湿科医师作为本病的主要诊断力量,提升患者在治疗决策中的参与程度,积极实施运动疗法,充分发挥中医药整体多维的特点,在减轻疼痛、改善情绪、降低不良反应等多方面起效,并倡导FMS治疗注重中西医并重和多学科联合治疗,旨在提高我国FMS诊疗水平。Fibromyalgia syndrome(FMS)is a refractory,chronic non-articular rheumatic disease characterized by widespread pain throughout the body,for which there are no satisfactory therapeutic drugs or options.There are rich Chinese medical therapies,and some non-drug therapies,such as acupuncture,Tai Chi,and Ba-Duan-Jin,have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body.FMS is taken as a disease responding specifically to traditional Chinese medicine(TCM)by the National Administration of Traditional Chinese Medicine in 2018.In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine,the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine,including rheumatology,psychology,acupuncture and moxibustion,and encephalopathy,with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine.The recommendations were reached on the difficulties in early diagnosis and solutions of FMS,mitigation of common non-specific symptoms,preferential analgesic therapy,TCM pathogenesis and treatment advantages,and direction of treatment with integrated Chinese and Western medicine.FMS is currently facing the triple dilemma of low early correct diagnosis,poor patient participation,and unsatisfactory benefit from pure Western medicine treatment.To solve the above problems,this paper suggests that rheumatologists should serve as the main diagnostic force of this disease,and they should improve patient participation in treatment decisionmaking,implement exercise therapy,and fully utilize the holistic and multidimensional features of TCM,which is effective in alleviating pain,improving mood,and decreasing adverse events.In addition,it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment,which is expected to improve the standard of diagnosis and treatment of

关 键 词：优势病种 早期诊断 中西医结合 多学科联合诊疗 专家指导建议 

分 类 号：R242[医药卫生—中医临床基础] R2-0[医药卫生—中医学] R2-031R593