سابِق|تال

Analysis of clinical characteristics and distribution rules of TCM patterns in 148 patients with fibromyalgia syndrome

  • role： First author第一作者
  • Affiliation：

    Inner Mongolia Medical University, Hohhot 010110, China

  • Introduction：郭子嘉，男，在读硕士生
GUO Zijia1,  
  • Affiliation：

    Inner Mongolia Medical University, Hohhot 010110, China

CHEN Feng1,  
  • Affiliation：

    Yunnan University of Chinese Medicine, Kunming 650500, China

LIU Junming2,  
  • Affiliation：

    Department of TCM Rheumatology, China-Japan Friendship Hospital, Beijing 100029, China

YAN Zeran3,  
  • role： Corresponding author通信作者
  • Affiliation：

    Department of TCM Rheumatology, China-Japan Friendship Hospital, Beijing 100029, China

  • Email：xuyuan2004020@163.com
  • Introduction：A/Prof. XU Yuan, Ph.D., Chief Physician, Master’s Supervisor. China-Japan Friendship Hospital, No.2, Yinghuayuan East Road, Chaoyang District, Beijing 100029. E-mail: xuyuan2004020@163.com
XU Yuan3*

ملخص

ObjectiveThis 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.MethodsA 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.ResultsFMS 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.ConclusionFMS 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.

مفهوم

fibromyalgia syndrome;clinical characteristics;cross-sectional study;liver depression transforming into fire;dampness accumulated due to spleen deficiency;deficiency of both the liver and kidney;traditional Chinese medicine pattern

References

  1. [1].
    TROUVIN AP, PERROT S． Is fibromyalgia an immune-mediated disease？[J/OL]. Joint Bone Spine, 2022, 89(4)：105397 [2023-05-03]. .
  2. [2].
    中华中医药学会风湿病分会，海峡两岸医药卫生交流协会风湿免疫病学专业委员会纤维肌痛综合征中西医研究学组，首都中西医结合风湿免疫病研究所. 中国纤维肌痛综合征诊疗指南[J]. 中华内科杂志，2023, 62(2)：129-146.
  3. [3].
    ERDRICH S, HAWRELAK JA, MYERS SP, et al. Determining the association between fibromyalgia, the gut microbiome and its biomarkers: a systematic review[J/OL]. BMC Musculoskelet Disord, 2020, 21(1)：181[2023-05-03]. .
  4. [4].
    HENAO-PEREZ M, LOPEZ-MEDINA DC, ARBOLEDA A, et al. Patients with fibromyalgia, depression, and/or anxiety and sex differences[J/OL]. Am J Mens Health, 2022, 16(4)：15579883221110351[2023-05-03]. .
  5. [5].
    焦娟，殷海波，冯兴华，等. 纤维肌痛症中医病名探讨[J]. 中医杂志，2019, 60(1)：20-23.
  6. [6].
    D'ONGHIA M, CIAFFI J, RUSCITTI P, et al. The economic burden of fibromyalgia: a systematic literature review[J/OL]. Semin Arthritis Rheum, 2022, 56: 152060[2023-05-03]. .
  7. [7].
    SIRACUSA R, PAOLA RD, CUZZOCREA S, et al. Fibromyalgia: pathogenesis, mechanisms, diagnosis and treatment options update[J/OL].Int J Mol Sci，2021, 22(8)：3891 [2023-05-03]. .
  8. [8].
    MAFFEI ME. Fibromyalgia: recent advances in diagnosis, classification, pharmacotherapy and alternative remedies[J/OL]. Int J Mol Sci, 2020, 21(21)：7877 [2023-05-03]. .
  9. [9].
    王承德，沈丕安，胡荫奇. 实用中医风湿病学[M].2版. 北京：人民卫生出版社，2009: 827-833.
  10. [10].
    李灿东，方朝义. 中医诊断学[M]. 北京：中国中医药出版社，2021: 13-190.
  11. [11].
    SARZI-PUTTINI P, GIORGI V, MAROTTO D, et al. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment[J]. Nat Rev Rheumatol, 2020, 16(11)：645-660.
  12. [12].
    ROBINSON RL, KROENKE K, MEASE P, et al. Burden of illness and treatment patterns for patients with fibromyalgia[J]. Pain Med, 2012, 13(10)：1366-1376.
  13. [13].
    VINCENT A, BENZO RP, WHIPPLE MO, et al. Beyond pain in fibromyalgia: insights into the symptom of fatigue[J/OL]. Arthritis Res Ther, 2013, 15(6)：221[2023-05-03]. .
  14. [14].
    RUSCHAK I, TOUSSAINT L, ROSSELLÓ L, et al. Symptomatology of fibromyalgia syndrome in men: a mixed-method pilot study[J/OL]. Int J Environ Res Public Health, 2022，19(3)：1724[2023-05-03]. .
  15. [15].
    KAIRYS AE, VALENTINE TR, WHIBLEY D, et al. Mind the mood: momentary depression and anxiety moderate the correspondence between subjective and objective cognitive functioning in fibromyalgia[J/OL]. Arthritis Care Res, 2023[2023-05-03]. .
  16. [16].
    GALVEZ-SÁNCHEZ CM, MUÑOZ LADRÓN DE GUEVARA C, MONTORO CI, et al. Cognitive deficits in fibromyalgia syndrome are associated with pain responses to low intensity pressure stimulation[J/OL]. PLoS One, 2018, 13(8)：e201488[2023-05-03]. .
  17. [17].
    ALCIATI A, CIRILLO M, MASALA IF, et al. Differences in depression, anxiety and stress disorders between fibromyalgia associated with rheumatoid arthritis and primary fibromyalgia[J]. Stress Health, 2021, 37(2)：255-262.
  18. [18].
    PENN IW, CHUANG E, CHUANG TY, et al. Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations[J/OL]. BMJ Open, 2019, 9(4)：e26581[2023-05-03]. .
  19. [19].
    SCHATZ RA, MOSHIREE B. Gastrointestinal and hepatic disease in fibromyalgia[J]. Rheum Dis Clin North Am, 2018, 44(1)：131-142.
  20. [20].
    LICHTENSTEIN A, TIOSANO S, AMITAL H. The complexities of fibromyalgia and its comorbidities[J]. Curr Opin Rheumatol, 2018, 30(1)：94-100.
  21. [21].
    MOLTO A, ETCHETO A, GOSSEC L, et al. Evaluation of the impact of concomitant fibromyalgia on tnf alpha blockers' effectiveness in axial spondyloarthritis: results of a prospective, multicentre study[J]. Ann Rheum Dis, 2018, 77(4)：533-540.
  22. [22].
    ATZENI F, SARZI-PUTTINI P. Neurobiological similarities between RA and fibromyalgia[J]. Nat Rev Rheumatol, 2018, 14(6)：324-325.
  23. [23].
    马淑惠，戴京璋. 纤维肌痛综合征的病证结合诊治[J]. 世界中医药，2018, 13(3)：781-784.
  24. [24].
    孙静，张春艳，刘春平，等. 纤维肌痛综合征的中医治疗[J]. 中国医刊，2014，49(12)：27-30.
  25. [25].
    何洁，黄珠英，杨海珍，等. 杨观虎教授诊治纤维肌痛综合征的临床经验[J]. 微创医学，2023, 18(3)：278-283.
  26. [26].
    李阳，孙雨若，付静思，等. 165例纤维肌痛综合征患者中医证候分布及特点[J]. 北京中医药大学学报，2022, 45(6)：630-636.
  27. [27].
    张柔曼，姜泉. 姜泉治疗纤维肌痛综合征的经验[J]. 中国中医骨伤科杂志，2019, 27(10)：83-84.
  28. [28].
    陈维，张静，林敏. 基于《黄帝内经》对纤维肌痛综合征针灸辨治的思考与再探讨[J]. 新中医，2021, 53(13)：15-21.

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