Fatigue is a tiring state, whether it is physical fatigue or psychological fatigue. When a person’s enthusiasm and motivation are erased, there is only a tired face. How to get rid of the invasion of fatigue and refuse the invasion of fatigue syndrome? There is a set of methods in traditional Chinese medicine, which are specially used for health care for those who have chronic fatigue.
At present, western medicine lacks special treatment methods for chronic fatigue syndrome, while traditional Chinese medicine can achieve obvious curative effect through syndrome differentiation and treatment, showing great advantages.
Chronic fatigue syndrome (hereinafter referred to as CFS) is a new disease gradually recognized by people after the 1980s. It is more common among middle-aged workers, especially women aged 30-40 years. The incidence rate is high. The typical symptoms are severe physical fatigue, dizziness, headache, memory decline, muscle and joint pain, loss of appetite, trance, fever and cold aversion. At present, western medicine lacks special treatment methods for this disease, while traditional Chinese medicine can achieve obvious curative effect through syndrome differentiation and treatment, showing great advantages. In order to achieve better results in the treatment of CFS with traditional Chinese medicine, some basic ideas and methods are proposed for reference.
1. Trace the source and smooth the flow to seek clues for the treatment of CFS with traditional Chinese Medicine
Tracing the source and flowing smoothly is to use the existing examples and knowledge in the past to understand and solve new problems, and even create new theories. For example, although CFS is a newly discovered and recognized disease, it is by no means a disease that has only occurred in recent years. There should be similar diseases in human history. This requires us to trace the origin and evolution of CFS related diseases in Chinese medical literature with a historical perspective and a scientific attitude, so as to inspire ideas, prompt research clues, and obtain the basis and methods to solve practical problems. In short, it is necessary to position CFS in Chinese medicine, so as to unify the understanding of CFS in Chinese medicine and make Chinese medicine treatment targeted.
According to the clinical manifestations of CFS, combined with the relevant contents of various theories of traditional Chinese medicine in the past dynasties, CFS is similar to Lily disease, visceral mania, various depression syndromes, deficiency and damage, etc. the syndrome differentiation and treatment methods of these diseases in traditional Chinese medicine can all be based on the treatment of CFS. But it is too general. In essence, CFS, as a comprehensive syndrome group, does not seem to be covered by single diseases such as lily disease. In view of this, the author has carefully compared and thought that it was more appropriate to locate the disease in the spleen and stomach injury described by Li Dongyuan. This is because: in terms of pathogenesis, CFS is often caused by long-term work stress, improper diet, weak body elements, low immunity, mental stimulation and infection with a certain virus, which is basically consistent with the pathogenic factors of spleen and stomach injuries; In terms of Pathology, CFS and splenogastric internal injury are both malnutrition, deficiency of five viscera and dysfunction of various systems; In terms of diagnosis, the clinical symptoms of CFS and splenogastric injuries are both chronic diseases of multiple systems of the body, and they have great identity; In terms of therapeutics, Li Dongyuan used ginseng, Astragalus membranaceus, Angelica sinensis, Schisandra chinensis, Cimicifuga, bupleurum and other components to Treat Spleen and stomach injuries. According to the pharmacological analysis of modern Chinese medicine, these drugs can improve the immune function of the body, improve blood circulation, regulate the cardiovascular system, make the myocardial contraction strong, relax completely and significantly, and have strong antibacterial and antiviral effects. Their efficacy almost covers all the treatment schemes of modern medicine for CFS (1).
2. Based on the clinic, standardize the TCM diagnostic criteria and syndrome differentiation guidelines of CFS
Although there is still a lack of special indications for the diagnosis of CFS in the medical community, Holmes formulated the following diagnostic criteria in 1988 according to the clinical manifestations of CFS. Main criteria: ① continuous or intermittent fatigue and weakness for more than half a year, which cannot be relieved after bed rest; ② According to the medical history, signs and laboratory results, exclude the symptoms that may be caused by other diseases. Secondary criteria: ① low fever; ② Sore throat; ③ Swelling and pain of neck and axillary lymph nodes; ④ Unexplained muscle weakness; ⑤ Myalgia; ⑥ Fatigue does not disappear 24 hours after physical activity; ⑦ Headache, wandering joint pain without redness and swelling; ⑧ Neurological or psychiatric symptoms; ⑨ Drowsiness or insomnia. Physical sign criteria: ① low fever (oral temperature 37.6 ~ 38.6 ℃, Anal temperature 37.8 ~ 38.8 ℃); ② Non exudative pharyngitis; ③ The anterior, posterior and axillary lymph nodes were enlarged. Holmes pointed out that CFS can be initially diagnosed if there are two main criteria, more than six secondary criteria, more than two physical signs criteria, or more than eight simple symptoms criteria (2).
After 10 years of in-depth research and improved understanding of CFS, it is found that there are still many defects in the diagnostic criteria of Holmes, such as the lack of detection of some viral antibodies, brain temporal lobe examination and so on, which need to be further improved. However, up to now, traditional Chinese medicine has not established a distinctive diagnostic standard and syndrome differentiation system for CFS, which has become a major problem faced by clinical practitioners of traditional Chinese medicine. Therefore, it is imperative to standardize the diagnostic criteria and syndrome differentiation guidelines of CFS. The author believes that the basic process and points for attention of standardizing the TCM diagnosis and syndrome differentiation program of CFS can be summarized into five points.
First, in accordance with the principle of combining disease differentiation and syndrome differentiation in traditional Chinese medicine, highlight the characteristics of traditional Chinese medicine and include them in the diagnosis of traditional Chinese medicine. Obviously, the diagnostic criteria for CFS proposed by Holmes is a model of Western medicine, which can be used for reference by Chinese medicine, but it can not follow suit. We should combine the diagnostic materials collected by traditional Chinese medicine, such as the signs of tongue and pulse, the attributes of symptoms, the changes of yin and Yang, and the characteristics of visceral diseases, to enrich the diagnostic content of CFS, so as to establish a diagnostic standard of CFS with traditional Chinese medicine characteristics.
Secondly, all the collected clinical manifestations of CFS are differentiated and compared, and their characteristics are grasped according to Holmes diagnostic criteria, and their attributes are determined according to the concept of traditional Chinese medicine. The attributes are always based on Yin and Yang, and can often be subdivided into reciprocal pairs of viscera, Qi and blood, cold and heat, deficiency and excess.
Third, based on the clinical practice of traditional Chinese medicine, list the main symptoms (necessary symptoms), secondary symptoms (reference symptoms) and concurrent symptoms (probable symptoms) of CFS respectively, and then use the method of matching the main symptoms with the secondary symptoms and concurrent symptoms to synthesize the clinical symptoms, analyze the attributes of the symptoms, classify them according to their attributes, or classify them by analogy, such as A1 (main symptoms) + a (secondary symptoms and concurrent symptoms) = a syndrome (type), A2 (main symptoms) + B (secondary symptoms and concurrent symptoms) = B syndrome (type). Thus, the prototype of syndrome differentiation was obtained.
Fourth, reexamine the symptoms that have been classified to see what their common attributes are? If the symptom attributes of CFS in syndrome types are consistent, its essential attributes are single and certain; If the attribute of symptoms is inconsistent, or even the opposite attribute exists at the same time, it is necessary to further analyze whether it belongs to “mixed and mixed views” or “true and false suspicions”. Finally, it is necessary to establish its syndrome differentiation type through deductive proof and practical test.
Fifthly, introduce modern content, use mathematical methods, formulate the domain value, range and parameter content of various indications of CFS, and find out the probability and weight of some symptoms and signs in the diagnostic criteria and syndrome differentiation outline, so as to obtain the essential attributes of CFS.
3. Carefully screen and establish the effective prescription of Chinese medicine for CFS
(1) Throughout the domestic literature reports on the treatment of CFS with traditional Chinese medicine in recent years, most of them are limited to sporadic case reports, such as Yupingfeng powder, Buzhong Yiqi pill, Danggui Buxue Decoction, etc. the main role is to strengthen the body and dispel evil factors, which is effective for the rehabilitation of patients with CFS who are weak and have low immune function for a long time.
(2) Acupuncture and moxibustion and prevention and rehabilitation of CFS. Acupuncture and moxibustion can dredge meridians, regulate qi and blood, neurohumoral fluid, improve the immune function of the body, stimulate, mobilize and enhance the disease resistance of the body. It can not only adapt to the symptoms of various systems of CFS, but also prevent the occurrence of CFS and help the recovery of normal functions of the human body. Traditional Chinese medicine should be put into clinical practice of prevention and treatment of CFS on the basis of establishing the principle of meridian and acupoint selection, which is a topic worthy of in-depth study and has promising prospects.
(3) Qigong, massage and prevention and rehabilitation of CFS. Qigong or massage, massage and other physical therapy can further improve the defense, stability and supervision functions by concentrating the will, adjusting the breathing, and controlling the movement, so as to achieve “spiritual internal defense” and “muscle like one”. According to the existing research results, qigong can effectively strengthen the adjustment function of the body, so as to strengthen the order of the body and finally achieve self-control of visceral physiological functions (3). The effects of Qigong, massage and massage in the human body are very beneficial to the prevention and rehabilitation of CFS.
The above ideas and methods of traditional Chinese medicine for the treatment of CFS are organically related to each other. In the process of research, we should prevent segmentation and one sidedness. If we can build a systematic academic system of TCM Prevention and treatment of CFS through our efforts, then we believe that the quality of TCM treatment of CFS will be improved to a new level.
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