[1]李喜媛,马麦丽娜,马晓飞,等.名中医田雪梅基于“肝-玄府”理论治疗纤维肌痛综合征经验[J].陕西中医,2025,46(11):1552-1556.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.021]
　LI Xiyuan,MA Mailina,MA Xiaofei,et al.Analysis of famous Chinese medicine doctor TIAN Xue-mei’s experience in treating fibromyalgia syndrome based on the Liver-Xuanfu theory[J].,2025,46(11):1552-1556.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.021]
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名中医田雪梅基于“肝-玄府”理论治疗纤维肌痛综合征经验
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年11期
页码:
1552-1556
栏目:
名中医经验
出版日期:
2025-11-05

文章信息/Info

Title:
Analysis of famous Chinese medicine doctor TIAN Xue-mei’s experience in treating fibromyalgia syndrome based on the Liver-Xuanfu theory
作者:
李喜媛1; 马麦丽娜1; 马晓飞1; 雷海桃2; 朱虹1; 王海东2; 田雪梅2; 陈平2
（1.甘肃中医药大学，甘肃 兰州 730000；2.甘肃省中医院风湿骨病中心，甘肃 兰州 730050）
Author(s):
LI Xiyuan1; MA Mailina1; MA Xiaofei1; LEI Haitao2; ZHU Hong1; WANG Haidong2; TIAN Xuemei2; CHEN Ping2
（1.Gansu University of Chinese Medicine,Lanzhou 730000，China；2.Gansu Provincial Hospital of Traditional Chinese Medicine Rheumatology and Bone Disease Centre,Lanzhou 730050，China）
关键词:
纤维肌痛综合征; 肝; 玄府; 疏肝; 田雪梅
Keywords:
Fibromyalgia syndrome; Liver; Xuanfu; Liver-smoothing; TIAN Xuemei
分类号:
R 441.1
DOI:
DOI:10.3969/j.issn.1000-7369.2025.11.021
文献标志码:
A
摘要:
纤维肌痛综合征（FMS）是一种以慢性广泛性肌肉骨骼疼痛为核心特征的慢性疼痛综合征，常伴有疲劳、焦虑、抑郁等非特异性症状，“中枢敏化”为主要发病机制。该疾病的诊断和治疗迄今仍为难点，西药以对症治疗为主，但对非疼痛症状改善有限且不良反应明显。中医学基于整体观念辨证论治，具有多靶点、多途径、综合发挥疗效的特点，可减轻症状、提高患者生活质量，属于中医优势病种。田雪梅主任医师基于“肝-玄府”理论治疗FMS的临床经验，探讨FMS的核心病机及其治疗思路。田雪梅主任医师认为，FMS的核心病机是“肝气滞塞，玄府开阖失度”“邪气蓄积，酿生肝痹”“五脏不安，玄府闭阍”，提出“调肝疏气畅玄、祛邪消积通玄、培元解痹振玄”的治疗法则，将“调理肝气”贯穿FMS治疗始终。结合病程进展分层论治：初期以柴胡疏肝散加减辛香通玄之品，解郁止痛以畅气机；中期以越鞠丸合三仁汤化裁，祛痰瘀、化湿浊以通玄府；久病则投解郁通痹汤联合升降散，扶正祛邪并举，佐大剂量黄芪振奋玄府功能。其用药特色在于“宏观调肝”与“微观通玄”相结合，既遵循“辛可开闭”之旨选用辛香走窜药物，又融合现代药理证实具有抗炎、改善微循环作用，为临床FMS的治疗提供了新思路。
Abstract:
Fibromyalgia syndrome (FMS) is a chronic pain syndrome with chronic widespread musculoskeletal pain as its core feature.It is often accompanied by non-specific symptoms such as fatigue,anxiety and depression.Central sensitization serves as the main pathogenesis.To date,the diagnosis and treatment of this disease remain challenging.Western medicine mainly focuses on symptomatic treatment.However,it has limited efficacy in improving non-pain symptoms and is associated with notable adverse reactions.Based on holistic concept and syndrome differentiation and treatment principle,traditional Chinese medicine (TCM) is characterized by multi-target,multi-pathway,and comprehensive therapeutic effects.It can alleviate symptoms and enhance quality of life of patients,thus being regarded as a disease category where TCM holds advantages.Director physician TIAN Xuemei’s clinical experience in treating FMS is based on the liver-Xuanfu theory.This paper explores the core pathogenesis and treatment strategies of FMS.Director TIAN believes that the core pathogenesis of FMS includes stagnation of liver Qi,abnormal opening and closing of Xuanfu,accumulation of pathogenic factors leading to the development of liver bi syndrome,and disharmony of the five zang organs and closure of Xuanfu.She puts forward the treatment principles of regulating liver qi to unblock Xuanfu,eliminating pathogenic factors and removing accumulation to open Xuanfu,and strengthening the healthy Qi and resolving Bi syndrome to invigorate Xuanfu,with regulating liver Qi running through the entire treatment process of FMS.In combination with the progression of the disease course,hierarchical treatment is implemented: In the early stage,modified Bupleurum powder for dredging the liver (Chaihu Shugan San) is used,adding pungent and aromatic drugs to open Xuanfu,relieve depression,and alleviate pain to promote Qi circulation.In the middle stage,modified Yueju pill combined with Three Kernel decoction (Sanren Tang) is applied to eliminate phlegm stasis,resolve dampness turbidity,and open Xuanfu.In cases of long-term illness,Jieyu Tongbi decoction combined with Shengjiang San is administered.This approach simultaneously strengthens the healthy Qi and eliminates pathogenic factors,and a large dose of astragalus membranaceus is added to invigorate the function of Xuanfu.The medication characteristics lie in the integration of macroscopic liver regulation and microscopic Xuanfu opening.It not only adheres to the principle of pungent drugs can open blocked passages by selecting pungent and aromatic drugs that can penetrate and circulate,but also incorporates modern pharmacological drugs proven to have anti-inflammatory effects and the ability to improve microcirculation,providing a new perspective for clinical treatment of FMS.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82460945）；甘肃省科技厅联合科研基金资助项目（23JRRA1535）；基于针刀医学平台的开发转化临床人才培养项目（甘组通字〔2023〕20号）；甘肃省名中医传承工作室建设项目（甘中医药发〔2024〕7号）
更新日期/Last Update: 2025-11-04