专家共识

老年性肩周炎中医全周期康复广东专家共识(2026年版)

Guangdong Expert Consensus on Traditional Chinese Medicine(TCM)Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)

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    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.

浅析乳腺癌化疗后骨髓抑制的中医研究进展

浅析乳腺癌化疗后骨髓抑制的中医研究进展

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乳腺癌化疗后骨髓抑制是临床常见不良反应,严重影响治疗依从性与疗效。中医药已形成系统防治体系,以“脾肾亏虚、气血不足”为核心病机,构建内治外治结合的诊疗模式。内治采用汤剂、中成药等,以健脾补肾、益气养血为法;外治依据经络理论,运用针刺、艾灸等手段,实现协同增效。本文梳理中医药治疗的理论与研究进展,旨在为临床应用与后续研究提供参考。
Bone marrow suppression after chemotherapy for breast cancer is a common clinical adverse reaction, which seriously affects the treatment compliance and efficacy. Traditional Chinese medicine has formed a systematic prevention and treatment system, with "spleen and kidney deficiency, qi and blood deficiency" as the core pathogenesis, and a diagnosis and treatment model that combines internal and external treatment. Internal treatment adopts decoction, traditional Chinese patent medicines and simple preparations, etc., with the method of strengthening spleen and kidney, supplementing qi and nourishing blood; External treatment is based on the theory of meridians, using acupuncture, moxibustion and other methods to achieve synergistic effects. This article reviews the theory and research progress of traditional Chinese medicine treatment, aiming to provide reference for clinical application and subsequent research.

中药穴位贴敷联合沙库巴曲缬沙坦对慢性心力衰竭患者中医证候及心功能的影响

Effect of traditional Chinese medicine acupoint application combined with sacubitril/valsartan on TCM syndromes and cardiac function in patients with chronic heart failure

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目的 分析中药穴位贴敷、沙库巴曲缬沙坦联合治疗在慢性心力衰竭(CHF)中的应用效果。方法 选取我院CHF患者90例(2024-08—2026-01),依据随机数字表分成两组,每组45例。对照组接受沙库巴曲缬沙坦治疗,研究组接受中药穴位贴敷联合沙库巴曲缬沙坦治疗。观察两组疗效、6min步行距离、中医证候积分、心功能[心脏指数(CI)、每搏输出量(SV)、左室射血分数(LVEF)]、心肌指标[脑钠肽(BNP)、肌钙蛋白Ⅰ(cTnⅠ)]、安全性。结果 研究组治疗效果优于对照组(P<0.05);治疗后,研究组中医证候积分、BNP、cTnⅠ低于对照组,6min步行距离、LVEF、CI、SV高于对照组(P<0.05);两组治疗期间不良反应无显著差异(P>0.05)。结论 中药穴位贴敷联合沙库巴曲缬沙坦治疗CHF效果显著,可减轻临床症状,改善心功能,减少心肌损伤。
Objective To analyze the clinical efficacy of combined therapy with traditional Chinese medicine acupoint application and sacubitril/valsartan in patients with chronic heart failure (CHF). Methods A total of 90 patients with CHF admitted to our Hospital from August 2024 to January 2026 were selected, and divided into two groups by random number table, with 45 cases in each group. The control group was treated with sacubitril/valsartan, while the study group received combined therapy of traditional Chinese medicine acupoint application and sacubitril/valsartan. The therapeutic efficacy, 6-minute walking distance, TCM syndrome score, cardiac function indexes [cardiac index (CI), stroke volume (SV), left ventricular ejection fraction (LVEF)], myocardial indicators [brain natriuretic peptide (BNP), cardiac troponin Ⅰ (cTnⅠ)] and safety were observed in both groups. Results The therapeutic efficacy of the study group was better than that of the control group (P<0.05). After treatment, the TCM syndrome scores, BNP and cTnⅠ levels in the observation group were lower, while the 6-minute walking distance, LVEF, CI and SV were higher compared with the control group (P<0.05). No significant between-group difference was found in adverse reactions during treatment (P>0.05). Conclusion Traditional Chinese medicine acupoint application combined with sacubitril/valsartan achieves remarkable efficacy in the treatment of CHF. It can relieve clinical symptoms, improve cardiac function and alleviate myocardial injury.

衰弱综合征的中医量表编制及信效度检验

Development and Validity and Reliability Testing of a Traditional Chinese Medicine Scale for Debility Syndrome

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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.

温肾利水汤联合贝前列素钠对老年原发性肾病综合征(脾肾阳虚证)患者临床疗效、中医证候积分、肾功能、免疫功能的影响

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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。

中医穴位疗法联合康复护理干预对脑瘫患儿积极影响分析

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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。

中医穴位疗法联合康复护理干预对脑瘫患儿积极影响分析

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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。

活血通络汤联合恩格列净对射血分数降低型心力衰竭患者中医证候积分及心功能的影响

Effects of Huoxue Tongluo Decoction combined with empagliflozin on traditional Chinese medicine syndrome scores and cardiac function in patients with heart failure with reduced ejection fraction

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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.

活血通络汤联合恩格列净对射血分数降低型心力衰竭患者中医证候积分及心功能的影响

Effects of Huoxue Tongluo Decoction combined with empagliflozin on traditional Chinese medicine syndrome scores and cardiac function in patients with heart failure with reduced ejection fraction

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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.

基于口腔-肠道微生物轴探讨中医药防治动脉粥样硬化的研究进展

Research Progress on the Prevention and Treatment of Atherosclerosis by Traditional Chinese Medicine Based on the Oral-Gut Microbiota Axis

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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.
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