148例纤维肌痛综合征患者临床特点与中医证候分布规律分析

郭子嘉; 陈峰; 刘峻铭; 鄢泽然; 徐愿

doi:10.3969/j.issn.1006-2157.2023.11.001

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148例纤维肌痛综合征患者临床特点与中医证候分布规律分析

“中医药防治风湿病”专题 | 更新时间：2023-12-08

- 148例纤维肌痛综合征患者临床特点与中医证候分布规律分析
- Analysis of clinical characteristics and distribution rules of TCM patterns in 148 patients with fibromyalgia syndrome
- 北京中医药大学学报 2023年46卷第11期页码：1481-1489
- 作者机构：
  
  1.内蒙古医科大学　呼和浩特　010110
  2.云南中医药大学
  3.中日友好医院中医风湿病科
- 作者简介：
  
  郭子嘉，男，在读硕士生
  # 徐愿，男，博士，主任医师，副教授，硕士生导师，主要研究方向：中医药治疗风湿病，E-mail: xuyuan2004020@163.com
- 基金信息：
  
  北京市自然科学基金面上项目(7232319);中华中医药学会青年求实项目(2021-QNQS-05)
- DOI：10.3969/j.issn.1006-2157.2023.11.001
  中图分类号： R255
- 纸质出版日期：2023-11-30，
  
  网络出版日期：2023-10-27，
  
  收稿日期：2023-07-09，
- 稿件说明：
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郭子嘉, 陈峰, 刘峻铭, 等. 148例纤维肌痛综合征患者临床特点与中医证候分布规律分析[J]. 北京中医药大学学报, 2023,46(11):1481-1489.

GUO Zijia, CHEN Feng, LIU Junming, et al. Analysis of clinical characteristics and distribution rules of TCM patterns in 148 patients with fibromyalgia syndrome[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(11):1481-1489.
郭子嘉, 陈峰, 刘峻铭, 等. 148例纤维肌痛综合征患者临床特点与中医证候分布规律分析[J]. 北京中医药大学学报, 2023,46(11):1481-1489. DOI： 10.3969/j.issn.1006-2157.2023.11.001.

GUO Zijia, CHEN Feng, LIU Junming, et al. Analysis of clinical characteristics and distribution rules of TCM patterns in 148 patients with fibromyalgia syndrome[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(11):1481-1489. DOI： 10.3969/j.issn.1006-2157.2023.11.001.

摘要

目的

分析纤维肌痛综合征(FMS)患者临床特点和中医证候分布规律，为FMS的中医诊治提供依据。

方法

采用前瞻性、横断面研究方法，纳入2022年4月—2023年4月于中日友好医院中医风湿病科就诊的148例FMS患者，观察疼痛诱发和加重因素、疼痛视觉模拟评分法(VAS)评分、疼痛部位、疼痛性质和FMS其他主要症状，分析证候特征。

结果

148例FMS患者中，因劳累、情绪刺激和气候变化诱发疼痛者分别占52.0%、48.6%和39.2%，因劳累、情绪刺激和气候变化加重者分别占64.9%、49.3%和54.1%；轻度、中度和重度疼痛分别占11.5%、47.3%和41.2%；左上、右上、左下、右下和中轴部位疼痛分别占89.2%、88.5%、90.5%、86.5%和93.2%，其中，以背部、腰部、右肩胛带区、右上臂和左肩胛带区疼痛较常见，分别占84.5%、81.8%、76.4%、75.0%和75.0%；重痛、酸痛和胀痛分别占69.6%、63.5%和52.7%。常见症状中，有疲劳、睡醒后仍觉疲乏、认知损害、睡眠障碍、情绪障碍、慢性头痛的患者分别占95.9%、91.2%、67.6%、88.5%、93.2%、71.6%；合并偏头痛、肠易激综合征和骨关节炎的患者分别占29.1%、16.9%和14.2%。使用聚类分析方法将FMS归纳为肝郁化火证(98.6%)、脾虚湿蕴证(95.3%)及肝肾不足证(16.9%)3类，而且FMS患者常表现为多种证候叠加，肝郁化火合并脾虚湿蕴证最常见(77.7%)。

结论

FMS患者常出现疲劳和情绪障碍，易受劳累、情绪刺激和气候变化诱发加重，肝郁化火-脾虚湿蕴证是最常见的证候类型。

Abstract

Objective

This study aimed to analyze the clinical characteristics and distribution rules of TCM patterns of patients with fibromyalgia syndrome (FMS) and provide a basis for the TCM diagnosis and treatment of FMS.

Methods

A prospective cross-sectional study was conducted in the Department of TCM Rheumatology at China-Japan Friendship Hospital

recruiting 148 FMS patients from April 2022 to April 2023. The observation indexes included pain triggering and exacerbating factors

pain VAS scores

pain locations

pain characteristics

and other major symptoms. Relevant TCM patterns were analyzed.

Results

FMS patients’ pain induced by fatigue

emotional stimulation

and climate change accounted for 52.0%

48.6%

and 39.2% of the FMS patients’ pain

respectively; these factors aggravated pain in 64.9%

49.3%

and 54.1% of patients

respectively. Mild

moderate

and severe pain were reported by 11.5%

47.3%

and 41.2% of the patients

respectively. The upper left region

upper right region

lower left region

lower right region

and central axis region accounted for 89.2%

88.5%

90.5%

86.5%

and 93.2% of the patients’ pain respectively. Regarding pain sites

the back

lumbar area

right scapular region

right upper arm

and left scapular region were more commonly affected

accounting for 84.5%

81.8%

76.4%

75.0%

and 75.0% respectively. Regarding the nature of pain

heavy

aching

and distending pain accounted for 69.6%

63.5%

and 52.7%

respectively. Regarding the common symptoms

fatigue

waking unrefreshed

cognitive symptoms

sleep disorder

emotional disorder

and chronic headache accounted for 95.9%

91.2%

67.6%

88.5%

93.2%

and 71.6%

respectively. Patients with combined migraine

irritable bowel syndrome

and osteoarthritis accounted for 29.1%

16.9%

and 14.2% respectively. The major types of TCM patterns with FMS

using cluster analysis

were liver depression transforming into fire (98.6%)

dampness accumulated due to spleen deficiency (95.3%)

and deficiency of both the liver and kidney(16.9%). Patients with FMS often have a combination of TCM patterns

in which liver depression transforming into fire combined with dampness accumulated due to spleen deficiency (77.7%) is the most common.

Conclusion

FMS is often characterized by fatigue and emotional disorder

easily aggravated by exertion

emotional stimulation

and climate change. The most common TCM pattern is liver depression transforming into fire combined with dampness accumulated due to spleen deficiency.

关键词

纤维肌痛综合征临床特点横断面研究肝郁化火脾虚湿蕴肝肾不足中医证候

Keywords

fibromyalgia syndromeclinical characteristicscross-sectional studyliver depression transforming into firedampness accumulated due to spleen deficiencydeficiency of both the liver and kidneytraditional Chinese medicine pattern

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