因气候与生活习惯影响,广东地区老年性肩周炎临床特点及康复需求具有独特性,亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案,广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起,省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识(2026年版)》。该共识以ICF框架为基础,立足肩周炎康复循证医学证据,结合多学科专家产教研实践经验,对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布,将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。
Due to climatic and lifestyle influences,the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features,necessitating the development of standardized and locally tailored rehabilitation protocols.To formulate regionally differentiated rehabilitation plans,the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)” through collaboration with multiple provincial institutions and experts.Based on the International Classification of Functioning,Disability and Health(ICF)framework and evidence-based rehabilitation medicine for periarthritis of the shoulder,this consensus integrates multidisciplinary expertise from industry,academia,and research to establish unified guidelines on ICF assessment,application of appropriate TCM techniques and rehabilitation therapies,implementation of stepwise intervention measures,and integrated TCM-Western medicine full-cycle rehabilitation approaches.The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder.
目的 编制适用于老年人群的衰弱综合征中医评估量表并检验其信度与效度。方法 通过文献研究及《中华医典》检索构建条目池,采用4轮德尔菲专家咨询及预调查筛选条目形成初量表;便利抽取300例老年患者行横断面调查,以Fried表型衰弱量表为校标,进行项目分析、Cronbach’s α系数、探索性因子分析及ROC曲线分析。 结果 经条目筛选最终形成含5个核心症状条目(表A)及38个证候条目(表B)的量表。表A校标关联效度r=0.929(P<0.05),AUC=0.957,灵敏度0.949,特异度0.859;表A+B校标关联效度r=0.648(P<0.05),AUC=0.827,灵敏度0.606,特异度0.911;总量表Cronbach's α=0.872。结论 所研制的衰弱综合征中医量表信效度良好,可用于老年人衰弱状态筛查及中医证型判别。
Objective: To develop a Traditional Chinese Medicine (TCM) assessment scale for frailty syndrome in the elderly and to evaluate its reliability and validity. Methods: An item pool was constructed through literature review and searches of the *Chinese Medical Canon*. A preliminary scale was developed through four rounds of Delphi expert consultation and a pilot survey. A cross-sectional survey was conducted using a convenience sample of 300 elderly patients. Using the Fried Phenotypic Frailty Scale as the gold standard, item analysis, Cronbach’s α coefficient, exploratory factor analysis, and ROC curve analysis were performed. Results: After item screening, the final scale comprised 5 core symptom items (Table A) and 38 syndrome items (Table B). For Table A, the criterion-related validity was r = 0.929 (P < 0.05), AUC = 0.957, sensitivity = 0.949, and specificity = 0.859; Table A+B showed a test-retest reliability of r = 0.648 (P < 0.05), an AUC of 0.827, a sensitivity of 0.606, and a specificity of 0.911; the total scale had a Cronbach’s α of 0.872. Conclusion: The developed Traditional Chinese Medicine (TCM) frailty syndrome scale demonstrates good reliability and validity and can be used for screening frailty in the elderly and for distinguishing TCM syndrome patterns.
目的 研究温肾利水汤联合贝前列素钠对老年原发性肾病综合征(PNS)患者T淋巴细胞亚群及肾功能的影响。方法 回顾性收集我院106例老年PNS患者临床资料(2024年4月-2026年1月),按照不同治疗方法分为研究组(n=55,温肾利水汤联合贝前列素钠)、对照组(n=51,贝前列素钠治疗)。比较两组治疗效果、中医证候积分、治疗前后肾功能[血尿素氮(BUN)、白蛋白(ABL)、血肌酐(SCR)]、T淋巴细胞亚群[CD4+、辅助性T细胞17(Th17)、CD3+]、不良反应。结果 治疗3个月后,研究组总有效率(92.73%)高于对照组(P<0.05);治疗3个月后,研究组主证积分、次证积分均低于对照组(P<0.05);治疗3个月后,研究组血清BUN、SCR水平低于对照组,ABL水平高于对照组(P<0.05);治疗3个月后,研究组CD4+、CD3+高于对照组,Th17低于对照组(P<0.05);两组不良反应发生率(5.45% VS 9.80%)相比,差异无统计学意义(P>0.05)。结论 温肾利水汤联合贝前列素钠治疗老年PNS患者能提高治疗效果,改善T淋巴细胞亚群水平,促进肾功能恢复。
目的 评估中医穴位疗法结合康复护理对脑瘫患儿的积极价值。方法 选取某社会福利院康复医院2024年12月至2025年12月间儿科收治的40例脑瘫患儿,通过随机数字表分为两组,对照组(20例)接受常规康复护理,观察组(20例)则联合应用中医穴位疗法,对比两种方案的康复效果。结果 观察组患儿的临床痉挛指数(包括肢体腱反射、肌张力及阵挛等维度)评分低于对照组,差异具统计学意义(P<0.05);观察组血清CD4+和CD4+/CD8+免疫功能指标均高于对照组(P<0.05);观察组在躯干控制测量量表(TCMS)、儿童睡眠习惯问卷(CSHQ)评估中的分数改善较对照组更优(P<0.05)。结论 将中医穴位疗法融入康复护理,对脑瘫患儿实施综合干预,有助于优化其睡眠质量,减轻肌张力异常,提升免疫力和平衡功能,为其康复提供有效支持。
目的 评估中医穴位疗法结合康复护理对脑瘫患儿的积极价值。方法 选取某社会福利院康复医院2024年12月至2025年12月间儿科收治的40例脑瘫患儿,通过随机数字表分为两组,对照组(20例)接受常规康复护理,观察组(20例)则联合应用中医穴位疗法,对比两种方案的康复效果。结果 观察组患儿的临床痉挛指数(包括肢体腱反射、肌张力及阵挛等维度)评分低于对照组,差异具统计学意义(P<0.05);观察组血清CD4+和CD4+/CD8+免疫功能指标均高于对照组(P<0.05);观察组在躯干控制测量量表(TCMS)、儿童睡眠习惯问卷(CSHQ)评估中的分数改善较对照组更优(P<0.05)。结论 将中医穴位疗法融入康复护理,对脑瘫患儿实施综合干预,有助于优化其睡眠质量,减轻肌张力异常,提升免疫力和平衡功能,为其康复提供有效支持。
目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.
目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.
动脉粥样硬化(AS)是心血管疾病的病理基础,口腔与肠道通过菌群移位、代谢互作及免疫联动共同构成口腔-肠道微生物轴,其稳态失衡通过菌群易位、代谢紊乱和屏障损伤等促进AS发生发展。中医药以整体观念与辨证论治为指导,多靶点调控口腔-肠道微生物平衡,抑制血管炎症与脂质沉积,发挥抗AS效应。本文系统阐述口腔-肠道微生物与AS的关联,探讨中医药调控微生态防治该病的研究进展,分析当前研究存在的局限并展望未来方向,为中医药防治AS提供新的思路与理论依据。
Atherosclerosis (AS) is the pathological basis of cardiovascular diseases. The oral cavity and the gut together constitute the oral-gut microbial axis through microbial translocation, metabolic interactions, and immune crosstalk. Dysbiosis of this axis promotes the occurrence and development of AS via bacterial translocation, metabolic disorders, and barrier damage. Guided by the holistic concept and syndrome differentiation-based treatment, traditional Chinese medicine (TCM) exerts anti-AS effects by multi-target regulation of the oral-gut microbial balance, inhibiting vascular inflammation and lipid deposition. This article systematically elaborates the association between the oral-gut microbiota and AS, explores the research progress of TCM in modulating microecology for the prevention and treatment of AS, analyzes the limitations of current studies, and prospects future directions, so as to provide new insights and theoretical basis for TCM in preventing and treating AS.
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.