纤维肌痛症中医病名探讨
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摘要
纤维肌痛症是一种特发性风湿病,以全身弥漫性疼痛、特定部位压痛为主要特征,同时具有多种非特异临床症状。中医病名常依据疾病的主要症状来命名,基于纤维肌痛症躯体疼痛部位与中医学"筋"的概念相符、核心症状弥漫性疼痛是筋痹的主要临床表现、由筋痹导致的肝痹与纤维肌痛症的众多非特异症状相符、纤维肌痛症好发于中老年女性与筋痹的内在病因相符,认为纤维肌痛症应归属于中医学"筋痹"范畴。
Fibromyalgia is an idiopathic rheumatic disease characterized by diffuse pain throughout the body and tenderness at specific sites,as well as a variety of non-specific clinical symptoms. The name of the disease in traditional Chinese medicine( TCM) is often based on the main symptoms. Based on the following four aspects,i. e. site of somatic pain: 1) fibromyalgia is consistent with the concept of "tendon"in TCM,2) the core symptom diffuse pain is the main clinical manifestation of tendon numbness. 3) the liver numbness and fibromyalgia caused by tendon numbness are consistent with many non-specific symptoms. 4) fibromyalgia occurs in middle-aged and elderly women and is consistent with the intrinsic etiology of tendon numbness; it is believed that fibromyalgia should be attributed to the category of "tendon numbness"in TCM.
Fibromyalgia is an idiopathic rheumatic disease characterized by diffuse pain throughout the body and tenderness at specific sites,as well as a variety of non-specific clinical symptoms. The name of the disease in traditional Chinese medicine( TCM) is often based on the main symptoms. Based on the following four aspects,i. e. site of somatic pain: 1) fibromyalgia is consistent with the concept of "tendon"in TCM,2) the core symptom diffuse pain is the main clinical manifestation of tendon numbness. 3) the liver numbness and fibromyalgia caused by tendon numbness are consistent with many non-specific symptoms. 4) fibromyalgia occurs in middle-aged and elderly women and is consistent with the intrinsic etiology of tendon numbness; it is believed that fibromyalgia should be attributed to the category of "tendon numbness"in TCM.
引文
[1]FITZCHARLES MA,MCDOUGALL J,STE-MARIE PA,et al. Clinical implications for cannabinoid use in the rheumatic diseases:potential for help or harm?[J] Arthritis Rheum,2012,64(8):2417-2425.
[2]WOLFE F,ROSS K,ANDERSON J,et al. The prevalence and characteristics of fibromyalgia in the general population[J]. Arthritis Rheum,1995,38(1):19-28.
[3]MCBETH J,JONES K. Epidemiology of chronic musculoskeletal pain[J]. Best Pract Res Clin Rheumatol,2007,21(3):403-425.
[4]VINCENT A,LAHR BD,WOLFE F,et al. Prevalence of fibromyalgia:a population-based study in Olmsted County,Minnesota,utilizing the Rochester Epidemiology Project[J]. Arthritis Care Res(Hoboken),2013,65(5):786-792.
[5]KIM SH,BAE GR,LIM HS. Prevalence and risk factors of fibromyalgia syndrome and chronic widespread pain in two communities in Korea-first report in Korean[J]. J Korean Rheum Assoc,2006,13(1):18-25.
[6]ROGER AS,EDMUND KML,RHONDA JS. The Prevalence of fibromyalgia syndrome in Chinese people in Hong Kong[J]. J Muscul Pain,2006,14(2):3-11.
[7]RUHMAN W. The earliest book on rheumatism[J]. Br J Rheumatol,1940,2:140-162.
[8]GOWERS WR. A Lecture on Lumbago:Its lessons and analogues:Delivered at national hospital for the paralysed and epileptic[J]. Br Med J,1904,1(2246):117-121.
[9]Twenty-Second Rheumatism Review. Review of the American and English literature for the years 1973 and 1974[J]. Arthritis Rheum,1976,19(6 Suppl):973-1223.
[10]YUNUS M,MASI AT,CALABRO JJ,et al. Primary fibromyalgia(fibrositis):clinical study of 50 patients with matched normal controls[J]. Semin Arthritis Rheum,1981,11(1):151-171.
[11]WOLFE F,SMYTHE HA,YUNUS MB,et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee[J]. Arthritis Rheum,1990,33(2):160-172.
[12]CHOY E,PERROT S,LEON T,et al. A patient survey of the impact of fibromyalgia and the journey to diagnosis[J]. BMC Health Serv Res,2010,10:102. doi:10. 1186/1472-6963-10-102.
[13]MU R,LI C,ZHU JX,et al. National survey of knowledge,attitude and practice of fibromyalgia among rheumatologists in China[J]. Int J Rheum Dis,2013,16(3):258-263.
[14]焦娟,张柔曼,姜泉.中医风湿专科医生对纤维肌痛综合征认知水平的调查[J].中医杂志,2017,58(20):1740-1742.
[15]HAUSER W,ABLIN J,FITZCHARLES MA,et al.Fibromyalgia[J]. Nat Rev Dis Primers,2015,1:15022.doi:10. 1038/nrdp. 2015. 22. Review.
[16]MEASE P,ARNOLD LM,CHOY EH,et al. Fibromyalgia syndrome module at OMERACT 9:domain construct[J]. J Rheumatol,2009,36(10):2318-2329.
[17]WOLFE F,CLAUW DJ,FITZCHARLES MA,et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity[J]. Arthritis Care Res(Hoboken),2010,62(5):600-610.
[18]WOLFE F,CLAUW DJ,FITZCHARLES MA,et al.2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria[J]. Semin Arthritis Rheum,2016,46(3):319-329.
[19]庞坚,曹月龙,詹红生,等.骨关节炎的“筋”“骨”之辨[J].上海中医药大学学报,2012,26(1):29-31.
[2]WOLFE F,ROSS K,ANDERSON J,et al. The prevalence and characteristics of fibromyalgia in the general population[J]. Arthritis Rheum,1995,38(1):19-28.
[3]MCBETH J,JONES K. Epidemiology of chronic musculoskeletal pain[J]. Best Pract Res Clin Rheumatol,2007,21(3):403-425.
[4]VINCENT A,LAHR BD,WOLFE F,et al. Prevalence of fibromyalgia:a population-based study in Olmsted County,Minnesota,utilizing the Rochester Epidemiology Project[J]. Arthritis Care Res(Hoboken),2013,65(5):786-792.
[5]KIM SH,BAE GR,LIM HS. Prevalence and risk factors of fibromyalgia syndrome and chronic widespread pain in two communities in Korea-first report in Korean[J]. J Korean Rheum Assoc,2006,13(1):18-25.
[6]ROGER AS,EDMUND KML,RHONDA JS. The Prevalence of fibromyalgia syndrome in Chinese people in Hong Kong[J]. J Muscul Pain,2006,14(2):3-11.
[7]RUHMAN W. The earliest book on rheumatism[J]. Br J Rheumatol,1940,2:140-162.
[8]GOWERS WR. A Lecture on Lumbago:Its lessons and analogues:Delivered at national hospital for the paralysed and epileptic[J]. Br Med J,1904,1(2246):117-121.
[9]Twenty-Second Rheumatism Review. Review of the American and English literature for the years 1973 and 1974[J]. Arthritis Rheum,1976,19(6 Suppl):973-1223.
[10]YUNUS M,MASI AT,CALABRO JJ,et al. Primary fibromyalgia(fibrositis):clinical study of 50 patients with matched normal controls[J]. Semin Arthritis Rheum,1981,11(1):151-171.
[11]WOLFE F,SMYTHE HA,YUNUS MB,et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee[J]. Arthritis Rheum,1990,33(2):160-172.
[12]CHOY E,PERROT S,LEON T,et al. A patient survey of the impact of fibromyalgia and the journey to diagnosis[J]. BMC Health Serv Res,2010,10:102. doi:10. 1186/1472-6963-10-102.
[13]MU R,LI C,ZHU JX,et al. National survey of knowledge,attitude and practice of fibromyalgia among rheumatologists in China[J]. Int J Rheum Dis,2013,16(3):258-263.
[14]焦娟,张柔曼,姜泉.中医风湿专科医生对纤维肌痛综合征认知水平的调查[J].中医杂志,2017,58(20):1740-1742.
[15]HAUSER W,ABLIN J,FITZCHARLES MA,et al.Fibromyalgia[J]. Nat Rev Dis Primers,2015,1:15022.doi:10. 1038/nrdp. 2015. 22. Review.
[16]MEASE P,ARNOLD LM,CHOY EH,et al. Fibromyalgia syndrome module at OMERACT 9:domain construct[J]. J Rheumatol,2009,36(10):2318-2329.
[17]WOLFE F,CLAUW DJ,FITZCHARLES MA,et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity[J]. Arthritis Care Res(Hoboken),2010,62(5):600-610.
[18]WOLFE F,CLAUW DJ,FITZCHARLES MA,et al.2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria[J]. Semin Arthritis Rheum,2016,46(3):319-329.
[19]庞坚,曹月龙,詹红生,等.骨关节炎的“筋”“骨”之辨[J].上海中医药大学学报,2012,26(1):29-31.