慢性疲劳综合征及其影响因素与中医体质的相关性及临床研究
|
摘要
步入21世纪以来,我国经济高速发展,人民生活条件有了极大提高。但在经济高速发展的同时,生活节奏日益加快,工作压力也越来越大,竞争也日趋激烈。在如此的大环境下,慢性疲劳综合征的发病率一路攀升,由于其持续时间长且易于反复发作,极大的影响到个人生活质量,也引起了医学界的广泛关注。中医体质学是一门极具个体化诊疗思想的新兴交叉学科,注重研究个体的体质特征、体质类型、体质差异规律及其与健康、疾病的关系。中医体质学极其适用于现代以人为中心的个体医学模式。因此,本研究在进行慢性疲劳综合征及其影响因素与中医体质的相关性分析的基础上,采用针灸与中医体质相结合的方式治疗慢性疲劳综合征,以期为中医个体化防治慢性疲劳综合征寻求客观依据和新的思路。
目的：
在综述慢性疲劳综合征以及中医体质学的研究进展基础上,通过调查研究,探讨慢性疲劳综合征及其影响因素与中医体质的相关性,提出针灸改善慢性疲劳综合征危险体质的临床思路,并将其应用于针灸临床实践,研究针灸体质调节治疗慢性疲劳综合征的临床疗效及安全性。
方法：
1.调查研究：对142例慢性疲劳综合征患者和]48例对照组人群,采用问卷调查与国际或国内公认量表评分相结合的方式,收集两组人群的主要特征、工作情况、家族史等流行病学资料,然后进行统计学分析。先采用两组比较的卡方检验对中医体质类型、相关因素进行分析,得出有统计学意义的因素,再纳入logistic回归分析,以探求中医体质类型与慢性疲劳综合征及其影响因素的相关性。
2.理论研究：在初步研究结果的基础上,结合相关文献,就针灸调治CFS危险体质(即气虚质、阳虚质)的思路进行论述。
3.临床研究：选择符合纳入标准的气虚质及阳虚质CFS患者60例,采用完全随机化分组方法,将60例病例随机分至治疗组和对照组各30例。治疗组给予针刺调体穴位,对照组给予常规针刺穴位,每周治疗3次,8次为一疗程,3个疗程后观察治疗结果。结果评价指标包括总体疗效评价,治疗前后症状积分、Chadler疲劳量表评价以及气虚、阳虚体质积分的评价。
结果：
1.调查研究结果：
(1)经统计学分析,病例组与对照组的体质类型分布有差异,主要体现在平和质、阳虚质和气虚质。将九种体质类型作为自变量,慢性疲劳综合征作为因变量,进一步做logistic回归分析。结果显示,在0.05检验水准下,自变量阳虚质(OR=3.113)、气虚质(OR=4.088)及平和质(OR=0.240)与因变量慢性疲劳综合征之间的联系有统计学意义。根据回归系数及0R估计值判断,阳虚质、气虚质是与CFS发生呈正相关的中医体质,即是慢性疲劳综合征发生的危险因素；平和质是CFS发生的保护因素。
(2)将两组人群各相关资料进行单因素统计学比较分析,显示在居住环境、经济状况、过度劳累、家庭不和、人际不协调、事业受挫、工作时间大于8小时,压力较大、饮食规律、嗜食肥甘厚腻、口味重、饮咖啡、运动习惯、睡眠小于7小时、性格及情绪16个方面有统计学差异。
将以上16个因素纳入多因素logistic回归,提示：在P<0.05水平,最终进入回归方程的影响因素有7个,它们分别是：X3(过度劳累)、X7(工作时间大于8小时)、X9(饮食规律)、X13(运动习惯)、X14(睡眠小于7小时)、X15(性格)及X16(情绪)。
以上7个自变量进行了哑变量化,统计结果提示：①X3(1)经常过度劳累与偶尔过度劳累(参照分类)比较有统计学差异,且为危险因素。X3(2)有时过度劳累与偶尔过度疲劳相比无差别。②与工作时间很少大于8小时相比,X7(1)经常及有时X7(2)大于8小时的工作时间是CFS产生的危险因素,有统计学差异。③X9(1)饮食很规律与饮食不规律者(参照分类)相比,二者有统计学差异,且X9(1)是保护因素。X9(2)与参照分类相比没有统计学意义。④X13(1)经常运动及X13(2)有时运动与不常运动(参照分类)相比,有统计学差异,且均为保护因素。⑤X14(1)睡眠经常小于7小时、X14(2)有时睡眠小于7小时与很少睡眠小于7小时(参照分类)相比,均有统计学差异,且为危险因素。⑥X15(2)内向性格相对于混合性格来说,有统计学差异,是CFS的危险因素。X15(1)外向性格则无明显差异。⑦X16(1)正性情绪及X16(2)负性情绪,与中等情绪(参照分类)相比较,均有统计学意义,其中X16(1)是CFS的保护因素,X16(2)则是危险因素。
(3)气虚质与X3(过度劳累)、X8(工作压力大)及X9(规律饮食)有关。回归结果提示：①X3(1)是“经常过度劳累”,与很少过度劳累(参照组)相比,二者有显著差别,且为危险因素。X3(2)“有时过度劳累”与参照组比较无统计学意义；②X8(1)工作压力经常都很大的人群相对于经常压力很小(参照组)的人群,体质容易出现气虚质的偏颇,是危险因素。⑧X9(1)“经常规律饮食”与偶尔规律饮食相比,有统计学差异,且为气虚质的保护因素。X9(2)则无明显差别。
(4)阳虚质则与各项影响因素无明显的相关性。
2.理论研究结果：
针灸调节气虚体质的常用经络是脾经、胃经、任脉及膀胱经,常用穴位有太白、足三里、气海、中脘、脾俞、胃俞。阳虚体质以任脉、督脉、。肾经及膀胱经为主；常用穴位是太溪、足三里、神阙、关元、肾俞、命门。调节两种体质较多用到的针灸方法有针刺、艾灸、穴位埋线及穴位敷贴。
3.临床研究结果：
研究所纳入的60例患者,经随机分组,治疗组及对照组各30例。其中,对照组由于患者私人原因脱落1例,故最终完成临床观察的有治疗组30例,病例组29例。
经统计学分析,两组患者在性别、年龄、病情、体质构成等方面无明显差异,具有可比性。治疗3个疗程后,总体疗效比较显示,两组治疗均有效,治疗组总有效率86.67%,对照组总有效率72.41%,经组间比较提示,治疗组的疗效明显优于对照组,P<0.05,有统计学意义。
治疗后两组患者的疲劳症状积分、Chadler疲劳量表积分及气虚、阳虚体质积分均较治疗前有显著改善(P<0.01),经组间积分差值比较,提示治疗组在改善疲劳症状积分、Chadler疲劳量表积分及气虚、阳虚体质积分方面较对照组更加显著(P<0.05),有统计学差异。
结论：
1.调查研究的结论：慢性疲劳综合征的危险体质是气虚质和阳虚质,保护体质是平和质；与慢性疲劳综合征的发生呈正相关的因素是：经济满意、经常饮食规律、经常运动。呈负相关的是：经常过度劳累、人际关系不协调、工作压力较大、睡眠小于7小时以及负性情绪；经常过度劳累和工作压力大是气虚质的危险因素,经常饮食规律是气虚质的保护因素。
2.理论研究的结论：针灸体质观自古有之,个体体质指导针灸治疗,针灸可调节、改善个体体质；针灸调节个体体质有一定的可行性。
3.临床研究的结论：对于气虚质、阳虚质的CFS患者,针灸调体能够显著改善其疲劳症状,以及气虚质、阳虚质的体质积分。总体疗效优于对照组(常规针剌组)；针灸调节体质治疗CFS,副反应小,安全性高。
Since the21st century, our country economy is in high speed development, the living conditions of people have greatly improved.But with the rapid development of economy, the pace of life is increasing rapidly, work pressure is also growing, competition is increasing fiercely. In such circumstances, the incidence rate of chronic fatigue syndrome climbed all the way. Due to its long duration and easy to break out repeatedly, the personal quality of life is greatly affectted by CFS and it has also aroused the widespread attention in medical community. The constitution of TCM is an individualized diagnosis method and it pay much attention to the study of individual constitution features, constitutional type, physical difference law and the relationship with health and disease. The constitution of TCM is extremely suitable for modern people-centric individual medical model. So in this study we do the research on chronic fatigue syndrome and its influence factors and the correlation analysis of TCM constitution, and to seek the objective basis and new ideas for individualization of TCM prevention and treatment of chronic fatigue syndrome.
Purpose:On the basis of the review of the research progress of chronic fatigue syndrome and the constitution of TCM, throughing clinical randomized sampling survey, to explore the correlation between chronic fatigue syndrome and its influencing factors and constitution of TCM, and to put forward a comprehensive clinical thinking of improving the risk constitution of chronic fatigue syndrome with acupuncture, and to provide theoretical and objective basis for clinical practice syndrome-based differentiation and treatment of CFS.
Methods:
1. Investigation:In142cases of patients with chronic fatigue syndrome and148cases of control group, useing the questionnaire survey combined with the international or domestic rating scale, to collecte of the main features of the two groups, work, family history and other epidemiological data, then carries on the statistical analysis. The two groups are compared by chi-square test to analyze the related factors,then conclude the factors that have statistical significance. Taking the factors again into the logistic regression analysis, to explore the correlation of the TCM constitution type and CFS and its influencing factors. Finally, put porward the acupuncture treatment ideas of TCM constitution combined with clinical on the basis of preliminary results.
2. Theory research:Based on preliminary research results, combined with the literature on acupuncture, CFS risk constitution (i.e., Qi deficiency, Yang deficiency) of the ideas were discussed.
3.Clinical study:choose the inclusion of60Qi deficiency and yang deficiency patients with CFS standard, using completely randomized grouping method,60cases were randomized to treatment group and control group with30cases in each. The treatment group was given acupuncture which can regulate constitution, the control group was given routine acupuncture treatment,3times a week,8times for a course of treatment, observation of treatment after3courses. The indexes of results including the overall evaluation of efficacy, symptom scores before and after treatment, the Chadler fatigue scale evaluation and evaluation of qi deficiency, Yang deficiency constitution integral.
Results:
1. The results of investigation:
(1)Thoughing statistics analysis, there are differences of TCM constitution between the case group and control group's physique type distribution, mainly reflected in the calm, Yang deficiency, qi deficiency constitution. Will be more than four in chronic fatigue syndrome meaningful physical type as the independent variable, chronic fatigue syndrome as a dependent variable, further logistic regression analysis. Results show that under the0.05inspection level, the independent variable qi deficiency constitution (OR=4.088), Yang deficiency constitution (OR=3.113) and the peaceful consititution (OR=0.240) and dependent variable of the relationship between the chronic fatigue syndrome was statistically significant, qi depression and chronic fatigue syndrome has no statistical significance. According to the regression coefficient and estimates OR judgments, Yang deficiency, qi deficiency of quality of traditional Chinese medicine (TCM) is positively correlated with CFS sufferer, is a risk factor for chronic fatigue syndrome occurred.
(2) There was no difference in the baseline level between case group and control group such as sex, age, height, weight, etc.Main characteristics to two groups, work situation and eating habits for statistical data related to the comparative analysis, is shown in the living environment, economic satisfaction, overwork, family discord, interpersonal disharmony, career setbacks, work time is more than eight hours, dietary laws, mind you, fat GanHou greasy, tastes heavy, drink coffee, exercise habits, sleep less than7hours, personality and emotional aspects such as statistically significant.
Incorporating the above factors into the mul Li-factor logistic regression, tip:in the P<0.05level, and ultimately into the regression equation of the nine factors, respectively is:X3(overfatigue), X7(overwork), X9(eating habits), X13(exercise habits), X14(less than7hours of sleep), X15(nature), X16(mood).
The above7independent variables for the dummy variable quantitative, statistical results suggest:(1) X3(1) often overfatigue and occasionally (see classification) is statistically significant, and the risk factors. X3(2) sometimes overwork difference compared with occasional fatigue.(2) with little more than8hours working time compared to X7(1) X7(2) often and sometimes greater than8hours working time are risk factors of CFS, there were significant differences.(3) X9(1)diet is regular and irregular diet (reference category) were compared, there was difference between two groups, having a regular diet X9is a protective factors.(4) X13(1)Regular exercise and X13(2) sometimes movement and compared classification, statistically significant, and were protective factors.(5)X14(1)and(2) compared with the basic classification is statistically significant, and they are the protective factors.(6) X15(2) introvert relative to the mixed character introversion, there is significant difference, is the risk factor of CFS.(7) Secondary emotions and X16(1)and(2) the positive emotions, compared with the negative emotions (see classification), all have statistical significance, and both are protective factors for CFS.
(3) Qi deficiency constitution has relationship with X3(overwork) X8(strong work pressure)and X9(regular diet). Often overwork is risk factors, strong work pressure and often eating regularly are protecting factor.
(4) Yang deficiency constitution has no relationship with the factors.
2. The results of theoretical research:
Main collateral channels used for regulating qi deficiency constitution with acupuncture is the spleen, stomach, Ren and bladder. Commonly used acupuncture points are Taibai(SP3), Zusanli(ST36), Zhongwan(CV12), Qihai(CV6), spleen shu(BL20), stomach shu(BL21). Main collateral channels used for regulating yang deficiency constitution with acupuncture is the Ren and Du meridian, kidney and bladder meridian. The most common used acupuncture points are Taixi(KI3), Zusanli(ST36), Shenque(CV8), Guanyuan(CV4), Shenshu(BL23), Mingmen(GV4).
3. The results of clinical research:
The60patients that included study were randomly divided into treatment group and control group, with30cases in each. One of the control group patient, due to personal reasons has falled off, the final completion of clinical observation of the treatment group contain30cases, the control group was29cases.
By statistical analysis, both group of patients had no significant difference in gender, age, illness, constitution structure, they can be compared. After3courses of treatment, overall curative effect comparison shows that two groups were effective, the total effective rate of treatment group was86.67%, the total efficiency of control group was72.41%. compared with two groups, the efficacy of the treatment group was significantly better than the control group, P<0.05, there was statistical significance.
After treatment,the symptoms of fatigue scale, Chadler fatigue scale scores and Qi deficiency, Yang deficiency constitution score were significantly improved than before treatment (P<0.01). the integral difference comparison between groups, the treatment group in improving the fatigue symptom score, Chadler fatigue scale scores and Qi and yang deficiency constitution scale better than the control group (P<0.05), there was significant statistical differences.
Conclusions:
1. Research conclusion:risk constitution of chronic fatigue syndrome is Qi deficiency and yang deficiency, protect the constitution is flat and matter; occurrence is positively related to the factors and chronic fatigue syndrome is:economic satisfaction, often diet, regular exercise. Negative correlation is:often overworked, lack of coordination, interpersonal relationship, work pressure, sleep less than7hours and negative emotion; often overworked and working pressure are risk factors of qi deficiency, often eating were protective factors of qi deficiency.
2. The individual physical guidance of acupuncture treatment, acupuncture can regulate, improve individual physique; acupuncture regulating individual constitution has certain feasibility.
3. For Qi deficiency, Yang deficiency in CFS patients, acupuncture modulation can significantly improve the symptoms of fatigue, and Qi deficiency, Yang deficiency constitution integral. The overall effect is better than the control group (acupuncture group); acupuncture treatment of regulating body CFS, small side effect, high security.
目的：
在综述慢性疲劳综合征以及中医体质学的研究进展基础上,通过调查研究,探讨慢性疲劳综合征及其影响因素与中医体质的相关性,提出针灸改善慢性疲劳综合征危险体质的临床思路,并将其应用于针灸临床实践,研究针灸体质调节治疗慢性疲劳综合征的临床疗效及安全性。
方法：
1.调查研究：对142例慢性疲劳综合征患者和]48例对照组人群,采用问卷调查与国际或国内公认量表评分相结合的方式,收集两组人群的主要特征、工作情况、家族史等流行病学资料,然后进行统计学分析。先采用两组比较的卡方检验对中医体质类型、相关因素进行分析,得出有统计学意义的因素,再纳入logistic回归分析,以探求中医体质类型与慢性疲劳综合征及其影响因素的相关性。
2.理论研究：在初步研究结果的基础上,结合相关文献,就针灸调治CFS危险体质(即气虚质、阳虚质)的思路进行论述。
3.临床研究：选择符合纳入标准的气虚质及阳虚质CFS患者60例,采用完全随机化分组方法,将60例病例随机分至治疗组和对照组各30例。治疗组给予针刺调体穴位,对照组给予常规针刺穴位,每周治疗3次,8次为一疗程,3个疗程后观察治疗结果。结果评价指标包括总体疗效评价,治疗前后症状积分、Chadler疲劳量表评价以及气虚、阳虚体质积分的评价。
结果：
1.调查研究结果：
(1)经统计学分析,病例组与对照组的体质类型分布有差异,主要体现在平和质、阳虚质和气虚质。将九种体质类型作为自变量,慢性疲劳综合征作为因变量,进一步做logistic回归分析。结果显示,在0.05检验水准下,自变量阳虚质(OR=3.113)、气虚质(OR=4.088)及平和质(OR=0.240)与因变量慢性疲劳综合征之间的联系有统计学意义。根据回归系数及0R估计值判断,阳虚质、气虚质是与CFS发生呈正相关的中医体质,即是慢性疲劳综合征发生的危险因素；平和质是CFS发生的保护因素。
(2)将两组人群各相关资料进行单因素统计学比较分析,显示在居住环境、经济状况、过度劳累、家庭不和、人际不协调、事业受挫、工作时间大于8小时,压力较大、饮食规律、嗜食肥甘厚腻、口味重、饮咖啡、运动习惯、睡眠小于7小时、性格及情绪16个方面有统计学差异。
将以上16个因素纳入多因素logistic回归,提示：在P<0.05水平,最终进入回归方程的影响因素有7个,它们分别是：X3(过度劳累)、X7(工作时间大于8小时)、X9(饮食规律)、X13(运动习惯)、X14(睡眠小于7小时)、X15(性格)及X16(情绪)。
以上7个自变量进行了哑变量化,统计结果提示：①X3(1)经常过度劳累与偶尔过度劳累(参照分类)比较有统计学差异,且为危险因素。X3(2)有时过度劳累与偶尔过度疲劳相比无差别。②与工作时间很少大于8小时相比,X7(1)经常及有时X7(2)大于8小时的工作时间是CFS产生的危险因素,有统计学差异。③X9(1)饮食很规律与饮食不规律者(参照分类)相比,二者有统计学差异,且X9(1)是保护因素。X9(2)与参照分类相比没有统计学意义。④X13(1)经常运动及X13(2)有时运动与不常运动(参照分类)相比,有统计学差异,且均为保护因素。⑤X14(1)睡眠经常小于7小时、X14(2)有时睡眠小于7小时与很少睡眠小于7小时(参照分类)相比,均有统计学差异,且为危险因素。⑥X15(2)内向性格相对于混合性格来说,有统计学差异,是CFS的危险因素。X15(1)外向性格则无明显差异。⑦X16(1)正性情绪及X16(2)负性情绪,与中等情绪(参照分类)相比较,均有统计学意义,其中X16(1)是CFS的保护因素,X16(2)则是危险因素。
(3)气虚质与X3(过度劳累)、X8(工作压力大)及X9(规律饮食)有关。回归结果提示：①X3(1)是“经常过度劳累”,与很少过度劳累(参照组)相比,二者有显著差别,且为危险因素。X3(2)“有时过度劳累”与参照组比较无统计学意义；②X8(1)工作压力经常都很大的人群相对于经常压力很小(参照组)的人群,体质容易出现气虚质的偏颇,是危险因素。⑧X9(1)“经常规律饮食”与偶尔规律饮食相比,有统计学差异,且为气虚质的保护因素。X9(2)则无明显差别。
(4)阳虚质则与各项影响因素无明显的相关性。
2.理论研究结果：
针灸调节气虚体质的常用经络是脾经、胃经、任脉及膀胱经,常用穴位有太白、足三里、气海、中脘、脾俞、胃俞。阳虚体质以任脉、督脉、。肾经及膀胱经为主；常用穴位是太溪、足三里、神阙、关元、肾俞、命门。调节两种体质较多用到的针灸方法有针刺、艾灸、穴位埋线及穴位敷贴。
3.临床研究结果：
研究所纳入的60例患者,经随机分组,治疗组及对照组各30例。其中,对照组由于患者私人原因脱落1例,故最终完成临床观察的有治疗组30例,病例组29例。
经统计学分析,两组患者在性别、年龄、病情、体质构成等方面无明显差异,具有可比性。治疗3个疗程后,总体疗效比较显示,两组治疗均有效,治疗组总有效率86.67%,对照组总有效率72.41%,经组间比较提示,治疗组的疗效明显优于对照组,P<0.05,有统计学意义。
治疗后两组患者的疲劳症状积分、Chadler疲劳量表积分及气虚、阳虚体质积分均较治疗前有显著改善(P<0.01),经组间积分差值比较,提示治疗组在改善疲劳症状积分、Chadler疲劳量表积分及气虚、阳虚体质积分方面较对照组更加显著(P<0.05),有统计学差异。
结论：
1.调查研究的结论：慢性疲劳综合征的危险体质是气虚质和阳虚质,保护体质是平和质；与慢性疲劳综合征的发生呈正相关的因素是：经济满意、经常饮食规律、经常运动。呈负相关的是：经常过度劳累、人际关系不协调、工作压力较大、睡眠小于7小时以及负性情绪；经常过度劳累和工作压力大是气虚质的危险因素,经常饮食规律是气虚质的保护因素。
2.理论研究的结论：针灸体质观自古有之,个体体质指导针灸治疗,针灸可调节、改善个体体质；针灸调节个体体质有一定的可行性。
3.临床研究的结论：对于气虚质、阳虚质的CFS患者,针灸调体能够显著改善其疲劳症状,以及气虚质、阳虚质的体质积分。总体疗效优于对照组(常规针剌组)；针灸调节体质治疗CFS,副反应小,安全性高。
Since the21st century, our country economy is in high speed development, the living conditions of people have greatly improved.But with the rapid development of economy, the pace of life is increasing rapidly, work pressure is also growing, competition is increasing fiercely. In such circumstances, the incidence rate of chronic fatigue syndrome climbed all the way. Due to its long duration and easy to break out repeatedly, the personal quality of life is greatly affectted by CFS and it has also aroused the widespread attention in medical community. The constitution of TCM is an individualized diagnosis method and it pay much attention to the study of individual constitution features, constitutional type, physical difference law and the relationship with health and disease. The constitution of TCM is extremely suitable for modern people-centric individual medical model. So in this study we do the research on chronic fatigue syndrome and its influence factors and the correlation analysis of TCM constitution, and to seek the objective basis and new ideas for individualization of TCM prevention and treatment of chronic fatigue syndrome.
Purpose:On the basis of the review of the research progress of chronic fatigue syndrome and the constitution of TCM, throughing clinical randomized sampling survey, to explore the correlation between chronic fatigue syndrome and its influencing factors and constitution of TCM, and to put forward a comprehensive clinical thinking of improving the risk constitution of chronic fatigue syndrome with acupuncture, and to provide theoretical and objective basis for clinical practice syndrome-based differentiation and treatment of CFS.
Methods:
1. Investigation:In142cases of patients with chronic fatigue syndrome and148cases of control group, useing the questionnaire survey combined with the international or domestic rating scale, to collecte of the main features of the two groups, work, family history and other epidemiological data, then carries on the statistical analysis. The two groups are compared by chi-square test to analyze the related factors,then conclude the factors that have statistical significance. Taking the factors again into the logistic regression analysis, to explore the correlation of the TCM constitution type and CFS and its influencing factors. Finally, put porward the acupuncture treatment ideas of TCM constitution combined with clinical on the basis of preliminary results.
2. Theory research:Based on preliminary research results, combined with the literature on acupuncture, CFS risk constitution (i.e., Qi deficiency, Yang deficiency) of the ideas were discussed.
3.Clinical study:choose the inclusion of60Qi deficiency and yang deficiency patients with CFS standard, using completely randomized grouping method,60cases were randomized to treatment group and control group with30cases in each. The treatment group was given acupuncture which can regulate constitution, the control group was given routine acupuncture treatment,3times a week,8times for a course of treatment, observation of treatment after3courses. The indexes of results including the overall evaluation of efficacy, symptom scores before and after treatment, the Chadler fatigue scale evaluation and evaluation of qi deficiency, Yang deficiency constitution integral.
Results:
1. The results of investigation:
(1)Thoughing statistics analysis, there are differences of TCM constitution between the case group and control group's physique type distribution, mainly reflected in the calm, Yang deficiency, qi deficiency constitution. Will be more than four in chronic fatigue syndrome meaningful physical type as the independent variable, chronic fatigue syndrome as a dependent variable, further logistic regression analysis. Results show that under the0.05inspection level, the independent variable qi deficiency constitution (OR=4.088), Yang deficiency constitution (OR=3.113) and the peaceful consititution (OR=0.240) and dependent variable of the relationship between the chronic fatigue syndrome was statistically significant, qi depression and chronic fatigue syndrome has no statistical significance. According to the regression coefficient and estimates OR judgments, Yang deficiency, qi deficiency of quality of traditional Chinese medicine (TCM) is positively correlated with CFS sufferer, is a risk factor for chronic fatigue syndrome occurred.
(2) There was no difference in the baseline level between case group and control group such as sex, age, height, weight, etc.Main characteristics to two groups, work situation and eating habits for statistical data related to the comparative analysis, is shown in the living environment, economic satisfaction, overwork, family discord, interpersonal disharmony, career setbacks, work time is more than eight hours, dietary laws, mind you, fat GanHou greasy, tastes heavy, drink coffee, exercise habits, sleep less than7hours, personality and emotional aspects such as statistically significant.
Incorporating the above factors into the mul Li-factor logistic regression, tip:in the P<0.05level, and ultimately into the regression equation of the nine factors, respectively is:X3(overfatigue), X7(overwork), X9(eating habits), X13(exercise habits), X14(less than7hours of sleep), X15(nature), X16(mood).
The above7independent variables for the dummy variable quantitative, statistical results suggest:(1) X3(1) often overfatigue and occasionally (see classification) is statistically significant, and the risk factors. X3(2) sometimes overwork difference compared with occasional fatigue.(2) with little more than8hours working time compared to X7(1) X7(2) often and sometimes greater than8hours working time are risk factors of CFS, there were significant differences.(3) X9(1)diet is regular and irregular diet (reference category) were compared, there was difference between two groups, having a regular diet X9is a protective factors.(4) X13(1)Regular exercise and X13(2) sometimes movement and compared classification, statistically significant, and were protective factors.(5)X14(1)and(2) compared with the basic classification is statistically significant, and they are the protective factors.(6) X15(2) introvert relative to the mixed character introversion, there is significant difference, is the risk factor of CFS.(7) Secondary emotions and X16(1)and(2) the positive emotions, compared with the negative emotions (see classification), all have statistical significance, and both are protective factors for CFS.
(3) Qi deficiency constitution has relationship with X3(overwork) X8(strong work pressure)and X9(regular diet). Often overwork is risk factors, strong work pressure and often eating regularly are protecting factor.
(4) Yang deficiency constitution has no relationship with the factors.
2. The results of theoretical research:
Main collateral channels used for regulating qi deficiency constitution with acupuncture is the spleen, stomach, Ren and bladder. Commonly used acupuncture points are Taibai(SP3), Zusanli(ST36), Zhongwan(CV12), Qihai(CV6), spleen shu(BL20), stomach shu(BL21). Main collateral channels used for regulating yang deficiency constitution with acupuncture is the Ren and Du meridian, kidney and bladder meridian. The most common used acupuncture points are Taixi(KI3), Zusanli(ST36), Shenque(CV8), Guanyuan(CV4), Shenshu(BL23), Mingmen(GV4).
3. The results of clinical research:
The60patients that included study were randomly divided into treatment group and control group, with30cases in each. One of the control group patient, due to personal reasons has falled off, the final completion of clinical observation of the treatment group contain30cases, the control group was29cases.
By statistical analysis, both group of patients had no significant difference in gender, age, illness, constitution structure, they can be compared. After3courses of treatment, overall curative effect comparison shows that two groups were effective, the total effective rate of treatment group was86.67%, the total efficiency of control group was72.41%. compared with two groups, the efficacy of the treatment group was significantly better than the control group, P<0.05, there was statistical significance.
After treatment,the symptoms of fatigue scale, Chadler fatigue scale scores and Qi deficiency, Yang deficiency constitution score were significantly improved than before treatment (P<0.01). the integral difference comparison between groups, the treatment group in improving the fatigue symptom score, Chadler fatigue scale scores and Qi and yang deficiency constitution scale better than the control group (P<0.05), there was significant statistical differences.
Conclusions:
1. Research conclusion:risk constitution of chronic fatigue syndrome is Qi deficiency and yang deficiency, protect the constitution is flat and matter; occurrence is positively related to the factors and chronic fatigue syndrome is:economic satisfaction, often diet, regular exercise. Negative correlation is:often overworked, lack of coordination, interpersonal relationship, work pressure, sleep less than7hours and negative emotion; often overworked and working pressure are risk factors of qi deficiency, often eating were protective factors of qi deficiency.
2. The individual physical guidance of acupuncture treatment, acupuncture can regulate, improve individual physique; acupuncture regulating individual constitution has certain feasibility.
3. For Qi deficiency, Yang deficiency in CFS patients, acupuncture modulation can significantly improve the symptoms of fatigue, and Qi deficiency, Yang deficiency constitution integral. The overall effect is better than the control group (acupuncture group); acupuncture treatment of regulating body CFS, small side effect, high security.
引文
1.赵瑞芹,冯敬.国内外亚健康问题的研究进展及对比分析.国外医学情报,2002,23(3)：14-17.
2.袁萍,梁伯衡.慢性疲劳综合征的流行病学特征.国外医学卫生学分册,2003,30(2)：70-74.
3.王琦.中医体质学[M],北京：人民卫生出版社,2005,第一版：2.
4. Sharpe MC, Archard LC, Banatvala JE, et al. Arec port chronic fatigue syndrome: guidelines for research[J]. J R SocMed,1991,84(2):118-1211.
5. Carruthers BM, Jain AK, De Meirleir KL, et al. Myagic encephalomyelitis/chronic fatigue syndrome:clinic calworking case definition, diagnostic and treatment protocols[J]. J Chronic Fatigue Syndr,2003,11(1):7-1151.
6. Fukuda K,Straus S,Hickie I,Sharpe M,Dobbins J, Komaroff A. The chronic fatigue syndrome:a comprehensive approach to its definition and study. Ann Intern Med,1994,121:953-959.
7. Working Group of the Royal Australasian College of Physieians. Chronie fatigue syndrome.Clinical Practive guidelines. Med J Aust,2002;176 Suppl:23-56.
8.张蓉,李峰,陈洁,等.慢性疲劳综合征流行特征的研究[J].中国康复医学杂志,2004,19(4)：296-297.
9.姚韧敏,丘明义.香港地区慢性疲劳综合征的初步调查与中医病机探讨[J].中西医结合学报,2005,3(5)：359-362.
10.门伯华,黄志坚,丁国允.亚健康状态的流行病学研究进展[J].现代预防医学,2005,32(5)：465-466.
11. Kawakami N, et al. [J]. Tohoku J Exp Med,1998,186:33241.
12. Lloyd AR. Hickie I, Boughton CR, et al. Prevalence of chronic fatigue syndrome in an Australian population. Med JAust,1990,153:522-528.
13. WesselyS, ChalderT, HirschS, etal.The Prevalence and morbidity of chronic fatigue and chronic fatigue syndrome:a Prospective Primary care study. Am J Publication Health,1997,87(9):1449.
14. Staus. History of chronic fatigue syndrome[J]. Rev Infect D is,1991,13:2.
15. Coyle PK, K rupp LB, Doster C, et al.Borrelia burgdorferi react ivity in patients with sereve persistent fatigue who are from a regionin which Lyme disease is endemic[J]. C lin In fectD is,1994,18:S24-27.
16. Sanders P,Korf J. Neuroaetiology of chronic fatigue syndrome:an overview [J].World Jbiol Psychiatry,2008,9(3):165-171.
17. Devanur LD, Kerr JR. Chronic fatigue syndrome[J]. Jclin Virol,2006,37(3):139-150.
18. Vincent. C. Lombardi, Francis W.Ruscetti,et al. Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Science,2009,326:585-589.
19. Baker E, Fujimura SF, Faden MB, et al. immunologic abnormali ties associated with chronic fatigue syndrome[J]. Clin Infect Dis,1994,18(1):136-141.
20. Lorusso L, Mikhaylova SV, Capelli E, et al. Immunol ogical aspects of chronic fatigue syndrome. Autoimmun Rev,2009,8 (4):287-291.
21. Nijs J, FremontM. Intracellular immune dysfunction in myalgic encephalom yelitis/ chronic fatigue syndrome:state of the art and therapeutic implications. Expert Opin Ther Targets,2008,12 (3):281-289.
22.刘定华,刘占东等.慢性疲劳综合征患者外周血淋巴细胞亚群及CD25-调节性T细胞表达的研究[J].标记免疫分析与临床,2011,18(2)：93-96.
23.曾庆亮.中医药治疗慢性疲劳综合征的文献分析研究[D].北京中医药大学,2006.
24.杨福霞,王玲等.针灸八会穴治疗慢性疲劳综合症的疗效及其对患者免疫功能的影响[J].中华中医药学刊,2010,9(28)：1904-1905.
25. Cleare AJ, Messa C, Rabiner EA, et al. Brain 5-HT1A receptor binding in chronic fatigue syndrome measured using positron emission tomography and [11C]WAY-100635[J]. Biol Psychiatry,2005,57(3):239-246.
26.戚倩,吴整军.慢性疲劳综合征的中西医研究进展[J]。中华中医药学刊,2010,12(28)2528-2530
27. Rivera J. Controversy on the diagnosis of fibromyalgia [J]. Rev Esp Reumatal, 2004,31:501-506.
28. Dem itrackM. Dale JK. S traus SE, eta.l Evidence for impaired activation of the hypothalamic pictuitary- adrenalax is in patient with chronic fatigue syndrome[J] J C lin Endocrino 1M etab,1991,73:1224-1234
29. Gaab J, HusterD, BabakA. et al. Low dose dexamethasone suppression test in chronic fatigue syndrome and health[J]. Psychosom Mad,2002,64(2):311-318.
30. Fuite J, Vernon SD, Broderick G. Neuroendocrine and immune network re-modeling in chronic fatigue syndrome:An exploratory analysis. Genomics[J].2008,9.:176-179.
31.Jerjes WK, Taylor NF, Peters TJ, et al. Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome[J]. Psychosom Med,2006,68(4):578-582.
32. A. Famer, J.Seourfield, et al. Is disabling fatigue in childhood influenced by genes[J].Psyehological Medieine,1999,29:279-282.
33. Kaushik N, Fear D, Richards SCM, et al. Gene expression in peripheral blood mononuclear cells from patients with chronic fatigue syndrome. J Clin Pathol 2005; 58:826-832.
34. Kerr JR, Petty R, Burke B, et al. Gene expression subtypes in patients with chronic fatigue syndrome/myalgic encephalomyelitis[J]. Jinfect Dis,2008,197(8):1171-1184.
35. Rangel L Garralda ME, Jeffs J, et al. Family health and characteristics in chronic fatigue syndrome, juvenile rheumatoid arthritis, and emotional disorders of childhood [J]. J Am Acad Child Adolesc Psychiatry,2005,44(2):150-158.
36.肖计划.心身疾病(上)[J].新医学,1999,30(10)：614.
37.美研究证实慢性疲劳综合征新病因[J].中国保健营养,2009,3(9)：14.
38.刘雁峰,王天芳.慢性疲劳综合征中西医研究概况[J],北京中医药大学学报,1997,20(5)：48-50.
39. Ware Nc. Society, mind and body in chronic fatigue syndrome:an anthropologieal View. Ciba Found Symp,1993,173:62-73.
40. Petrie KJ, Booth RJ, Elder H. etal. Psychological influences on the perception of immune function [J]. sychol Med,1999,29:391-397.
41. Theorell T,Blomkvist V, Lindh G, et al. Critical life events, infections,and symptoms during the year preceding chronic fatigue syndrome:an examination of CFS patients and subjects with a nonspecific life crisis[J]. Psychosom Med,1999,61(3):304-310.
42. Dobbins JG. Natelson BH. Brassloff I, etal. Physical behavioral and psychological risk factors for chronic fatugue syndrome:a central role for stress[J]. Journal of Chronic Fatigue Syndrome.1995,1:43-58.
43.张振贤,张烨,吴丽丽等.慢性疲劳综合征与中医体质及社会心理危险因素相关性调查[J].辽宁中医杂志.2011,38(1)：22-25.
44.村上正人.如何看待慢性疲劳综合征患者的主诉[J].日本医学介绍,1998,19：133.
45. Peterson PK, Shepard J, MacresM, et al. Acontrol led trial of intravenous immunoglobulin G in chronic fatigue syndrome [J]. Am J Med,1990,89:554-560.
46. Lloyd A, Hickie I, Brockman A, et al. Immunologic and psychological therapy for patients with chronic fatigue syndrome:a double blind, placebo controlled trial[J]. Am JMed,1993,94:197-203.
47.姚大志,张全志.慢性疲劳综合征的基础研究及展望[J].鸡西大学学报,2009,9(1)：152-J54.
48. SharpeM, Hawton K, Simkin S, et al. Cognitive behaviour therapy for chronic fatigue syndrome:a randomised controlled trial[J]. BMJ,1996,312:22-26.
49.Knoop H, Blei jenberg G, GielissenMF, etal. Isafull recovery possible after cognitive behavioural therapy for chronic fatigue syndrome [J]. Psychother Psychosom,2007,76 (3):171-176.
50. John. MalouffJM, Thorsteinsson EB,Rooke SE, et al. Efficacy of cognitive behavioral therapy for chronic fatigue syndrome:A meta analysis [J]. Clinical PsychologyReview,28 2008:736-745.
51. Price J R, Mitchell E, Tidy E, et al. Cognitive behaviour therapy for chronic fatigue syndrome in adults [J/OL]. Cochrane Database Syst Rev,2008:001-027.
52.唐双阳,黄祁平等.慢性疲劳综合征与运动及免疫功能研究进展[J].中国公共卫生.2007,5(23)：625-627.
53. Samoilovych VA, Hutarieva NV, Tondii LD, et al. Effect of physical factors on bioelectric properties of cell nuclEI of buccal epithelium in students with chronic fatigue syndrome [J]. Lik Sprava,2005, (5-6):60-64.
54. Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease [J].Scand J Med Sci Sports,2006,16(1):53-63.
55. McCrone, et al. Cost-effectiveness of cognitive behavioural, graded exercise and usual care for patients with chronic fatigue in primary care [J].Psychol Med,2004,34: 991-999.
56.卓杰先,谷礼燕.循序渐进运动疗法治疗慢性疲劳综合征的相关研究[J].北京体育大学学报.2007.6：801-802.
57.赵燕.运动对慢性疲劳综合征大鼠神经免疫功能影响[J].中国公共卫生.2010,3：374-375.
58.Nijs J, De Meirleir K, Meeus M, et al. Chronic fatigue syndrome:intracellular immune regulations as a possible etiology for abnormal exercise response [J]. Med Hypotheses,2004,62(5):759-765.
59.杜国亮,张磊等.《黄帝内经》中相关“血气”“气血”论述辨析.辽宁中医药大学学报,2009,,11(3) ：13-14.
60.彭履祥.调气法的运用体会.中医专题讲座选(第二集).北京：人民卫生出版社,1981：205。
61.陈钢,盛昭园等.辨证治疗慢性疲劳综合征40例临床观察.江苏中医药,2011,43(3)：46-47.
62.王敏.慢性疲劳综合征的临床表现.中国社区医师,2003,19(17)：75,239.
63.吴峥嵘.中国医药辨证治疗慢性疲劳综合征.湖北中医杂志,2006,28(7)：22.
64.樊敏.慢性疲劳综合征的中医药诊疗现状浙江中西医结合杂志,2000,10(9)：575-576.
65.周立东.慢性疲劳证的中医病理生理学初探[J].中国病理生理杂志.1999,5(15)：13.
66.刘晓庄.中医药治疗慢性疲劳综合征评析.中医药研究1995,(3)：7-9.
67.胡兵,魏群利.慢性疲劳综合征辨治探要.安徽中医学院学报,2003,22(4)：1-3.
68.潘善余.慢性疲劳综合征的中医证治探讨.浙江中医杂志,2008,43(1)：29.
69.奚好君,史海霞.益气健脾法治疗慢性疲劳综合征50例.光明中医,2009,24(4)：754.
70.时学英.逍遥散治疗肝郁脾虚型慢性疲劳综合征的疗效及其对患者免疫功能的影响[J].浙江中医杂志,2007,42(7)：394-395
71.宫晶书,程金莲,王和天.滋补肝’肾汤治疗疲劳综合征的体会[J].首都医药,2004,(18)42-43.
72。陈兴华,黎璐茜,章闻,等.针刺治疗慢性疲劳综合征随机对照研究[J].中国针灸,2010,30(7)：533-536.
73.刘明,苏全德,郭芸倩。针灸治疗慢性疲劳综合征临床观察[J].现代中医药,2009,29(2)48-49.
74.王敬乔,周国平,刘小卫等.整体经络针刺法治疗慢性疲劳综合征的临床观察[J].湖南中医药大学学报,2010,30(9)：216-225
75.饶晓明,罗昭娜等.热敏灸治疗慢性疲劳综合征33例[J].江西中医药,2011,5(42)：66-67
76.兰彩虹.非瘢痕灸治疗慢性疲劳综合征的体会[J].贵阳中医学院学报,2011,33(1)：78-79.
77.陈秀玲,徐凯等.艾灸关元、气海穴治疗慢性疲劳综合征临床观察[J].新中医,2011,43(2)：109-110
78.刘长征,雷波.中医推拿治疗慢性疲劳综合征的随机对照研究[J].辽宁中医杂志,2012,37(2)：272-273.
79.卢文志,姜长利,周学礼等.足部按摩治疗慢性疲劳综合征[J].中国民间疗法,1996,(5)：34.
80.胡彩华,欧阳庆宜.平衡火罐治疗慢性疲劳综合征疗效观察[J].现代中西医结合杂志,2007,16(7)：935-936.
81.肖国民,周永芬等.华佗夹脊排罐法对慢性疲劳综合征患者生活质量的影响[J].西部中医药,2011,24(7)：86-87.
82.李丽英,穴位埋线治疗慢性疲劳综合征120例[J].中医外治杂志,2011,21(2)：45-46
83.杨才德,包金莲,宋建成.埋线和针灸治疗慢性疲劳综合征疗效的临床观察[J].医药卫生,2008,37(2)：186.
84.苗茂,阿古拉,何金柱.体针结合耳针贴压治疗慢性疲劳综合征64例[J].中国针,2005,25(4)： 292.
85.郭春媛,药物拔罐配合点刺放血治疗慢性疲劳综合征临床分析[J].实用中医药杂志,2007,23(6)：344-345.
86.匡调元.人体体质学-中医学个性化诊疗原理[M].上海：上海科学技术出版社.2003：137.
87.王琦.中医体质学[M].北京：中国医药科技出版社,1995.96-195.
88.刘淑萍.气虚体质研究的渊源及发展[J].内蒙古中医药.2001,12：92.
89.何裕民.体质研究—现时代中西医学的最佳交融点[J].医学与哲学,1996,17(6)：288.
90。清·陈复正辑订.幼幼集成.北京：人民卫生出版社,1988：4-68.
91.傅杰英,中医体质养生[M].鹭江出版社.2009：29.
92.匡调元.体质病理学研究[J].成都中医学院学报,1978,3(2)：3-17.
93.何裕民,刘文龙.新编中医基础理论[M].北京：北京医科大学中国协和医科大学联合出版社,1996：116-121.
94.中华中医药学会.中医体质分类与判定标准[J].世界中西医结合杂志,2009,4(4)：303.
95.何丽清,闫立,杨涛等.586例膝骨关节炎中医证型聚类分析与中医体质的关系[J].辽宁中医药大学学报.2012,14(07)：52-54.
96.万生芳.甘肃省高校教师亚健康人群中医体质类型调查与分析[J].甘肃中医学院学报.2012.29(3)：52-55
97.薛丽飞.老年抑郁症患者体质调查研究[J].北京中医药.2012,19(6)：5-6.
98.程兰,曹立幸,周霞.女性体质类型与子宫内膜异位症发病的相关性研究[J].辽宁中医杂志.2012,39 (2)0：30-302.
99.朱燕波,王琦等.中医体质类型与高血压的相关性研究[J].中西医结合学报,2010,8(1)：40-45
100.王娜娜,吴承玉.阳虚体质与病、证的相关性研究[J].南京中医药大学学报,2008,24(1)：4-5.
101.周昭辉,徐志锐,庄礼兴等.浅谈瘀血体质与中风病的防治[J].光明中医,2009,24(5)：792-794.
102.姜峰.季节性过敏性鼻炎患者中医体质特点研究[J].中国中医基础医学杂志,2007,13(9)：705-706.
103.姜峰.过敏性鼻炎与中医体质的关系[J].中华中医药杂志,2008,23(2)：140-141.
104.陈宝艳,李坤寅,曾蕾.从中医体质论治产后恶露不绝的临床研究[J].辽宁中医杂志.2012,39(4)：702-704.
105.王利平,王焕焕.补肾丸结合中医体质辨识治疗排卵障碍性不孕症临床观察[J].中医学报.2011,26(158)：877-878.
106.盛国光.中医体质学说与肝病临床辨治[J].光明中医,2008,23(3)：261-262.
107.匡调元,张伟荣,丁镛发.等.寒体与热体的研究[J].中医杂志.1995,,36(9)553-556.
108.骆斌,王琦.痰湿体质论析[J].安徽中医学院学报,1999,18(5)：10-11.
109.王睿林.气虚体质者外周血基因表达谱初步研究(D).北京：北京中医药大学.2005.
110.高洁,吕凤娟,林蒋海.中医痰湿体质与HLA-Ⅱ类基因相关性研究[J].陕西中医.2007,28(5)：622-624.
111.李英帅.阳虚、阴虚体质理论及代谢组学比较研究(D).北京：北京中医药大学,2009：56.
112.田栓磊.血瘀体质理论及其外周血基因表达谱的研究(D).北京：北京中医药大学.2009：49.
113.冯娜,贺娟,王琦.气郁体质相关差异基因研究[J].中国中西医结合杂志.2011,31(1)：48-51.
114.叶骞,叶平,李慧等.自然流产患者中医体质与凝血功能相关性的临床研究[J].浙江中医杂志.2012,47(])：24-25.
115.骆斌,张蓉,李峰.体质与慢性疲劳综合征的相关性研究[C].北京,第三届全国中医体质学术研讨会,2005：72-74。
116.张振贤,张烨,吴丽丽等.慢性疲劳综合征与中医体质及社会心理危险因素相关性调查[J].辽宁中医杂志.2011,38(1)：2226.
117.张振贤,吴丽丽,张烨等.慢性疲劳综合征的中医体质与证型研究[C].北京,人民大会堂中医治未病与亚健康高峰论坛暨首届亚健康经络调理学术研讨会,2009：46-54.
1. Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome:a comprehensive approach to its definition and study [J]. Ann Intern Med,1994,121(12):953959.
2.中华中医药学会.中医体质分类与判定[M].中国中医药出版社,2009.
3. Chalder T, Berelowitz G, Pawlikowska T, et al. Development of a fatigue scale [J]. J Psychosom Res,1993,37(2):147-153.
4. Watson D, Clark LA, Tel legen AlDevelopment and Validation of Brief Measures of Positive and Negative Affect:The PANAS ScaleslJournal of Personality and Social Psychology,1988; 54 (6):1063- 1070。
5.黄丽,杨廷忠,季忠民.正性负性情绪量表的中国人群适用性研究[J].中国心理卫生杂志,2003,171：54-56.
6.匡调元.人体体质学[M].上海：上海科学技术出版社.2003.8：225.
7.王琦.中医体质学.人民卫生出版社,2005,80-81.
8.张惠敏,郑守曾.气虚体质的研究进展[J].北京中医药大学学报,2004,27(1)：14-16.
9.潘宇政,陈业强,陈永斌,等.阴虚、阳虚、气虚证病人免疫功能的变化[J].广两医科大学学报,1999,2：16-18.
10.陈辉.中医气虚证的量化指标初探[J].中国中西医结合杂志,1998,18(7)：391.
11.王琦,姚实林,董静,等.阳虚体质者内分泌及免疫功能变化[J].中西医结合学报,2008,6(12)：1226-1232,
12.刘锐,杨世兴,乔成林,等.46例阳虚病人几种内分泌激素放射免疫测定的临床观察[J].陕西中医,1985,6(7)：30.
13.张家敬,郑敏.3H-TdR掺入法SAC诱导B淋转在SLE中医辨证中的意义[J].浙江中医杂志,1989,24(9)：417.
14.龚咏梅.职业女性的心理健康及调适[J].黑河学刊.2010,149(1)：57-58.
15.钱令嘉.应激与应激医学[J].疾病控制杂志.2003,7(5)：393-394
16.舒晓兵,廖建桥.工作压力研究：一个分析的框架[J].华中科技大学学报人文社会科学版.2002(5)：121-123.
17.陈浮芸.“治未病”思想认识近况[J].陕西中医学院学报,2007,30(6)：65-66.
18.王琦.中医体质三论[J].北京中医药大学学报.2008,31(10)：653-655.
1.胡春雨.浅谈脾胃与气虚体质的相关性[J].陕西中医.2006,7(6)：767-769.
2.王琦.论辨体论治的科学意义及其应用(二)[J].浙江中医药大学学报.2006,30(3)：220-224.
3.张新普,李敏,薛丹.阴虚体质易感疾病针灸调治规律探析[J].上海中医药大学学报,2012,26(6) ：30-32.
4.袁卓珺.王琦教授关于阳虚体质、阴虚体质的调体方法[J].中华中医药学刊.2012,30(10)：2187-2189.
5.刘立公,顾杰,刘婕等.古代文献中任脉及其腧穴主治的统计报告[J].针灸临床杂志.2010,26(4)： 6-8.
6.杨松堤,聂卉,孟凤仙.背俞穴临床应用与中医整体观[J].中医药学报,2000(6)：47.
7.曾芳,通调督脉治疗老年痴呆的理论探讨[J].四川中医.2004,22(9)：19-21.
8.刘立公,胡冬裴.古代文献中各类病证的常用经穴探讨[J].针灸临床杂志.2011,10(3)：67.
9.吴兴全,魏晓光,王之虹.固本培元手法治疗慢性疲劳综合征(脾。肾阳虚型)30例临床观察[J].长春中医药大学学报.2011,27(1)：91-92.
10.张伟,陈明人.失眠从膀胱经论治[J].江西中医学院学报.2011,23(4)：4-5.
11.刘立公,顾杰,沈雪勇等.古代文献中膀胱经及其腧穴主治的统计报告[J].上海针灸杂志.2004,23(]2)：42-43.
12.巍振义,张小黎.针刺原穴引起肢体温度变化的观察[J].针灸临床杂志,1995,11(4)：23.
13.王少军.井原穴皮温差的临床观察[J].辽宁中医杂志,1995,22(4)：178.
14.赵斌斌,李万瑶,络华亭.太白穴的临床功效[J].蜜蜂杂志.2009,2：31.
15.郁清琳.原穴证治规律的古代文献研究[D].广州：广州中医药大学,2012：31-33.
16.李婷,陈小兵.电针太白穴对实验性脾虚家兔的影响[J].中国中医药信息杂志,1999,6(5) ：25-26.
17.杨晓慧,张红石.针灸气海穴对小鼠抗疲劳、耐缺氧作用的影响[J].长春中医学院学报,2006.22(1)：68.
18.王维,李荣亨.针灸关元、气海穴对气虚证小鼠耐疲劳能力与免疫指标的影响[J],中国中医急症,2008,17(10)：1433-1434.
19.吴坤显,廖方正,曾红兵.针刺对实验性“。肾阳虚”、“。肾阴虚”动物病理组织形态的影响[J].河南中医,1998,4：20-21.
20.潘海燕,王永德,单秋华.电针太溪、阴谷对慢性肾脏病患者肾动脉血流的即刻效应[J].山东中医杂志,2008,27(5)：320-321.
21.姚红.肾虚证的针灸临床疗效观察[J].河南中医,1997,17(2)：111-112.
22.陈汉平,翟道荡,刘骏,等.艾灸“中脘”对小鼠S180,抑制作用的实验研究[J].江苏中医,1997,18(1)：27.
23.翟道荡,丁邦友,刘蓉,等.艾灸不同穴位调节ACTH、β-EP和免疫功能作用的研究[J].针刺研究,1996,21(2)：77.
24.王浩,申国明,汪克朋.电针中脘、胃俞对大鼠运动及血清胃动素、胃泌素水平的影响[J].安徽中医学院学报,2011,30(4)：37-39.
25.黄顺,王浩,黄学勇,等.电针胃俞募穴对胃扩张模型大鼠胃内压及血清胆囊收缩素-8、胃泌素水平的影响[J].安徽中医学院学报,2013,(1)：44-47.
26.王述菊,孙国杰,杜艳军,等.针刺对胃运动异常大鼠调节作用的神经机制研究[J].中国中医急症.2008(3)：352-353.
27.强肖文.调体在慢性疲劳综合症治疗中的临床疗效观察[D].广州：广州中医药大学,2011：16-19.
28.郑宁.温阳益气针灸方对治疗气虚质单纯性肥胖的研究[J].中国初级卫生保健,2012,8(9) ：92-93.
29.叶子怡,欧碧阳,林嬿钊,等.阳虚体质人群的健康评测特点分析[J].广州中医药大学学报,2010.27(4)：411-413.
30.李亚东,高洪泉、朱梅,等.针刺老年大鼠“足三里”“关元”穴对NO、SOD、MDA以及免疫影响的实验研究[J].中国针灸,2002,22(11)：121-122.
31.鲍毅梅,李汶阳,宋晓平.天灸关元、命门穴对佐剂性关节炎大鼠细胞免疫功能影响的比较研究[J].针灸临床杂志,2010,26(9)：54-56.
32.刘海燕.针灸调体治疗阳虚质痰瘀型痤疮的临床研究[D].广州：广州中医药大学.2011：24-25.
33.宋少军,李学玉,韩秀华,等.灸关元、大椎改善阳虚证血液流变指标的临床研究[J].辽宁中医杂志,2011,35(8)
34.王浩,申国明,黄顺,等电针胃俞募穴对大鼠胃运动及迷走背核复合体中胃动素和胃泌素表达的影响[J].安徽中医学院学报,2012,31(1)：27-29.
35.魏庆兴,菊地一搏,郑义弘,等.针灸预防大鼠应激性胃溃疡作用的实验研究[J].中国针灸,]997.17(10)：608.
36.王志成.艾灸治疗脾胃气虚型胃下垂30例[J].中国针灸,2006,,26(12)：895.
37.罗英华,罗伟君,唐纯志.针刺背俞穴对慢性疲劳大鼠氧化应激的影响[J].中医药导报,2012.18(6)：63-64.
38.樊云.推拿足三里。肾俞穴对阳虚模型大鼠CD4～+/CD8～+与IL-2影响的实验研究[D].湖北湖北中医学院,2005：19-21.
39.王英姿,刘小飞.艾灸结合穴位埋线调理阳虚体质[J].光明中医.2011,26(4)：758-759.
40.陈国远,向科明.微火针治疗肾阳虚证238例[J].中国针灸,2011,31(11)：1056.
41.靳勇,何冰.穴位敷贴在阳虚证中的临床应用[J].中国中医药现代远程教育,2010,8(10)：37.
42.刘立公,顾杰.古代文献中胃经及其腧穴主治的统计报告[J].上海针灸杂志.2003,22(4)：41-42.
43.何学斌,吴耀,罗济民,等.针灸对气虚大鼠红细胞免疫功能影响的实验研究[J].针剌研究,2003.28(3)：189-191.
44.冯春生.陈夏六君汤联合艾箱灸治疗脾胃气虚型功能性消化不良45例[J].中医研究,2012,6：62-63.
45.周俊亮,潘奔前,刘友章.穴位按摩改善气虚体质的临床研究[J].中医药临床杂志,2008,20(2)：130-131.
46.官星,董晓彤,王双昆,等.电针对阳虚大鼠神经内分泌系统的影响[J].中国中医基础医学杂志,2000,6(6)：57-60.
47.陈雄华,刘又香、王华,等.针灸“足三里”“关元”穴对阳虚大鼠免疫功能影响的比较研究[J].中国针灸,2000,9：43-45.
48.赵彩娇,范郁山,陆燕萍,等.艾灸“神阙”穴对肾阳虚家兔血清SOD的影响[J].中国针灸,2011.31(4)：342-346.
49.白桦,刘晓力,宋雅芳,等.脾肾阳虚证红细胞免疫功能改变的初步探讨[J].内蒙古中医药,1996,1：41.
50,廖运新,李金华.附子饼灸对老年人红细胞免疫功能的影响[J].湖南中医学院学报,1996,3(2)：24-25.
51.赵长信,赵昕,张惠华.针灸治疗阳虚证及对免疫功能的影响[J].中医杂志,1986,4：36.
52.贾跃进,王艳,刘琰,等.附子药饼穴位敷贴对阳虚体质的干预作用[J].河南中医,2011,31(9)：1043-1044.
53.何桂兰,袁申平,柯晓英.改良天灸法治疗慢性肾脏病肾阳虚证的临床研究[J].河北中医,2011,33(11)：1680-1682.
54.张日宏,张佩江.论体质与针刺调整作用的关系[J].河南中医,1991,11(65)：29-30.
55.袁萍,鲍春龄,袁莉等.五脏俞透刺治疗慢性疲劳综合征的临床观察[J].同济大学学报(医学版).2010,31(6)：102-104.
56.鲍春龄,袁萍,李立秋.阴阳气血配穴法针刺治疗慢性疲劳综合征临床观察[J].上海针灸杂志,2008,27,(6)：11-12.
57.王琦,姚实林,董静,等.阳虚体质者内分泌及免疫功能变化[J].中西医结合学报,2008,6(12)：1226-1232.
58.崔瑾,申定珠,熊芳丽.针灸膈俞对白细胞共同抗原及免疫功能的影响[J].四川中医,2006,24(2)：100-102.
59.李晓泓,韩毳,张露芬,等.艾灸(大椎)穴抗应激作用的实验研究[J].中国行为医学科学,2002,11(5)：495-497.
60.刘旭光,黄迪君,郝亮,等.艾灸对类风湿性关节炎大鼠下丘脑「垂体」肾上腺皮质轴的影响[J].中国中医基础医学杂志,2003,9(2)：57-59.
61.唐照亮,宋小鸽,李俊,等.艾灸抗炎免疫作用的实验观察与分析[J].针刺研究,1996,21(2)：67.
62.张永艳.脐灸疗法干预阳虚体质人群的疗效观察[J].针刺研究.2012,37(5)：409-411.
63.王芳.针灸改善阳虚体质治疗岭南痤疮的临床研究[D].广州：广州中医药大学,2010：28.
64.庞勇,李季,冯卓等.壮医药线点灸与雀啄灸对气虚质亚健康人群体质调养效果的比较[J]针灸临床杂志.2011,27(11).
65.伦新.实用针灸手法学[M].北京：人民卫生出版社,2004：481.
66.孙国杰.针灸学[M].北京：人民卫生出版社.2011,4：557.
67.崔小娜,庄礼兴,徐世芬.三伏天灸与三伏针剌对免疫学影响的对比研究[J].光明中医,2007,6：12-13.
68.曹晓慧.穴位敷贴治疗慢性肾脏病肾阳虚证、肾阴虚证的疗效观察[J].中国民族民间医药,2013,4：80-81.
69.关青,国生,付国兵.敷脐疗法对阳虚偏颇体质的干预研究[J].中国中医药信息杂志.2012,19(9)：79.
70.张永艳.脐灸疗法干预阳虚体质人群的疗效观察[J].针刺研究,2012,37(5)：409-411.
1. Fukuda K, Straus SE, Hickie], et al. The chronic fatigue syndrome:a comprehensive approach to its definition and study [J]. Ann Intern Med,1994,121(12):953959.
2.中华中医药学会.中医体质分类与判定[M].中国中医药出版社,2009.
3.王启才.针灸治疗学[M].北京：中国中医药出版社,2007.
4.郑筱萸.中药新药临床指导原则[M].北京：中国医药科技出版社,2002.
5. ChalderT, BerelowitzG,HerehisF. Development of a fatigue scale. Journal of Psvehosomatic researeh。Vo137(2),Feb 1993:37:147—153.
6.鲁明源.《内经》体质思想及应用——湿热体质与冠心病[D].山东：山东中医药大学,2001：20
7.匡调元.人体体质学——中医学个性化诊疗原理[M].上海：上海科学技术出版社,2003：171.
8.陈雪功.治病求本论析[J].安徽中医学院学报,2001,20(1)：5-7.
9.匡调元.人体体质学[M].上海：上海科学技术出版社,2003：219-220.
10.卢依平.辨体质——执简驭繁的临床辨证方法[J].中国中医药现代远程教育,2011,9(8)：114-115.
11.孙广仁.中医基础理论[M].北京：中国中医药出版社,2002,：298-300.
12.王琦.论中医体质研究的3个关键问题(下)[J].中医杂志,2006,,17(5)：330-332.
13.张蕾.中西医结合治疗慢性疲劳综合征[J].现代中西医结合杂志,2007,16(23)：3365.
14.欧阳崇志.浅谈体质因素在中医临床治疗上的应用[J].光明中医,2011,26(1)：11-12.
2.袁萍,梁伯衡.慢性疲劳综合征的流行病学特征.国外医学卫生学分册,2003,30(2)：70-74.
3.王琦.中医体质学[M],北京：人民卫生出版社,2005,第一版：2.
4. Sharpe MC, Archard LC, Banatvala JE, et al. Arec port chronic fatigue syndrome: guidelines for research[J]. J R SocMed,1991,84(2):118-1211.
5. Carruthers BM, Jain AK, De Meirleir KL, et al. Myagic encephalomyelitis/chronic fatigue syndrome:clinic calworking case definition, diagnostic and treatment protocols[J]. J Chronic Fatigue Syndr,2003,11(1):7-1151.
6. Fukuda K,Straus S,Hickie I,Sharpe M,Dobbins J, Komaroff A. The chronic fatigue syndrome:a comprehensive approach to its definition and study. Ann Intern Med,1994,121:953-959.
7. Working Group of the Royal Australasian College of Physieians. Chronie fatigue syndrome.Clinical Practive guidelines. Med J Aust,2002;176 Suppl:23-56.
8.张蓉,李峰,陈洁,等.慢性疲劳综合征流行特征的研究[J].中国康复医学杂志,2004,19(4)：296-297.
9.姚韧敏,丘明义.香港地区慢性疲劳综合征的初步调查与中医病机探讨[J].中西医结合学报,2005,3(5)：359-362.
10.门伯华,黄志坚,丁国允.亚健康状态的流行病学研究进展[J].现代预防医学,2005,32(5)：465-466.
11. Kawakami N, et al. [J]. Tohoku J Exp Med,1998,186:33241.
12. Lloyd AR. Hickie I, Boughton CR, et al. Prevalence of chronic fatigue syndrome in an Australian population. Med JAust,1990,153:522-528.
13. WesselyS, ChalderT, HirschS, etal.The Prevalence and morbidity of chronic fatigue and chronic fatigue syndrome:a Prospective Primary care study. Am J Publication Health,1997,87(9):1449.
14. Staus. History of chronic fatigue syndrome[J]. Rev Infect D is,1991,13:2.
15. Coyle PK, K rupp LB, Doster C, et al.Borrelia burgdorferi react ivity in patients with sereve persistent fatigue who are from a regionin which Lyme disease is endemic[J]. C lin In fectD is,1994,18:S24-27.
16. Sanders P,Korf J. Neuroaetiology of chronic fatigue syndrome:an overview [J].World Jbiol Psychiatry,2008,9(3):165-171.
17. Devanur LD, Kerr JR. Chronic fatigue syndrome[J]. Jclin Virol,2006,37(3):139-150.
18. Vincent. C. Lombardi, Francis W.Ruscetti,et al. Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Science,2009,326:585-589.
19. Baker E, Fujimura SF, Faden MB, et al. immunologic abnormali ties associated with chronic fatigue syndrome[J]. Clin Infect Dis,1994,18(1):136-141.
20. Lorusso L, Mikhaylova SV, Capelli E, et al. Immunol ogical aspects of chronic fatigue syndrome. Autoimmun Rev,2009,8 (4):287-291.
21. Nijs J, FremontM. Intracellular immune dysfunction in myalgic encephalom yelitis/ chronic fatigue syndrome:state of the art and therapeutic implications. Expert Opin Ther Targets,2008,12 (3):281-289.
22.刘定华,刘占东等.慢性疲劳综合征患者外周血淋巴细胞亚群及CD25-调节性T细胞表达的研究[J].标记免疫分析与临床,2011,18(2)：93-96.
23.曾庆亮.中医药治疗慢性疲劳综合征的文献分析研究[D].北京中医药大学,2006.
24.杨福霞,王玲等.针灸八会穴治疗慢性疲劳综合症的疗效及其对患者免疫功能的影响[J].中华中医药学刊,2010,9(28)：1904-1905.
25. Cleare AJ, Messa C, Rabiner EA, et al. Brain 5-HT1A receptor binding in chronic fatigue syndrome measured using positron emission tomography and [11C]WAY-100635[J]. Biol Psychiatry,2005,57(3):239-246.
26.戚倩,吴整军.慢性疲劳综合征的中西医研究进展[J]。中华中医药学刊,2010,12(28)2528-2530
27. Rivera J. Controversy on the diagnosis of fibromyalgia [J]. Rev Esp Reumatal, 2004,31:501-506.
28. Dem itrackM. Dale JK. S traus SE, eta.l Evidence for impaired activation of the hypothalamic pictuitary- adrenalax is in patient with chronic fatigue syndrome[J] J C lin Endocrino 1M etab,1991,73:1224-1234
29. Gaab J, HusterD, BabakA. et al. Low dose dexamethasone suppression test in chronic fatigue syndrome and health[J]. Psychosom Mad,2002,64(2):311-318.
30. Fuite J, Vernon SD, Broderick G. Neuroendocrine and immune network re-modeling in chronic fatigue syndrome:An exploratory analysis. Genomics[J].2008,9.:176-179.
31.Jerjes WK, Taylor NF, Peters TJ, et al. Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome[J]. Psychosom Med,2006,68(4):578-582.
32. A. Famer, J.Seourfield, et al. Is disabling fatigue in childhood influenced by genes[J].Psyehological Medieine,1999,29:279-282.
33. Kaushik N, Fear D, Richards SCM, et al. Gene expression in peripheral blood mononuclear cells from patients with chronic fatigue syndrome. J Clin Pathol 2005; 58:826-832.
34. Kerr JR, Petty R, Burke B, et al. Gene expression subtypes in patients with chronic fatigue syndrome/myalgic encephalomyelitis[J]. Jinfect Dis,2008,197(8):1171-1184.
35. Rangel L Garralda ME, Jeffs J, et al. Family health and characteristics in chronic fatigue syndrome, juvenile rheumatoid arthritis, and emotional disorders of childhood [J]. J Am Acad Child Adolesc Psychiatry,2005,44(2):150-158.
36.肖计划.心身疾病(上)[J].新医学,1999,30(10)：614.
37.美研究证实慢性疲劳综合征新病因[J].中国保健营养,2009,3(9)：14.
38.刘雁峰,王天芳.慢性疲劳综合征中西医研究概况[J],北京中医药大学学报,1997,20(5)：48-50.
39. Ware Nc. Society, mind and body in chronic fatigue syndrome:an anthropologieal View. Ciba Found Symp,1993,173:62-73.
40. Petrie KJ, Booth RJ, Elder H. etal. Psychological influences on the perception of immune function [J]. sychol Med,1999,29:391-397.
41. Theorell T,Blomkvist V, Lindh G, et al. Critical life events, infections,and symptoms during the year preceding chronic fatigue syndrome:an examination of CFS patients and subjects with a nonspecific life crisis[J]. Psychosom Med,1999,61(3):304-310.
42. Dobbins JG. Natelson BH. Brassloff I, etal. Physical behavioral and psychological risk factors for chronic fatugue syndrome:a central role for stress[J]. Journal of Chronic Fatigue Syndrome.1995,1:43-58.
43.张振贤,张烨,吴丽丽等.慢性疲劳综合征与中医体质及社会心理危险因素相关性调查[J].辽宁中医杂志.2011,38(1)：22-25.
44.村上正人.如何看待慢性疲劳综合征患者的主诉[J].日本医学介绍,1998,19：133.
45. Peterson PK, Shepard J, MacresM, et al. Acontrol led trial of intravenous immunoglobulin G in chronic fatigue syndrome [J]. Am J Med,1990,89:554-560.
46. Lloyd A, Hickie I, Brockman A, et al. Immunologic and psychological therapy for patients with chronic fatigue syndrome:a double blind, placebo controlled trial[J]. Am JMed,1993,94:197-203.
47.姚大志,张全志.慢性疲劳综合征的基础研究及展望[J].鸡西大学学报,2009,9(1)：152-J54.
48. SharpeM, Hawton K, Simkin S, et al. Cognitive behaviour therapy for chronic fatigue syndrome:a randomised controlled trial[J]. BMJ,1996,312:22-26.
49.Knoop H, Blei jenberg G, GielissenMF, etal. Isafull recovery possible after cognitive behavioural therapy for chronic fatigue syndrome [J]. Psychother Psychosom,2007,76 (3):171-176.
50. John. MalouffJM, Thorsteinsson EB,Rooke SE, et al. Efficacy of cognitive behavioral therapy for chronic fatigue syndrome:A meta analysis [J]. Clinical PsychologyReview,28 2008:736-745.
51. Price J R, Mitchell E, Tidy E, et al. Cognitive behaviour therapy for chronic fatigue syndrome in adults [J/OL]. Cochrane Database Syst Rev,2008:001-027.
52.唐双阳,黄祁平等.慢性疲劳综合征与运动及免疫功能研究进展[J].中国公共卫生.2007,5(23)：625-627.
53. Samoilovych VA, Hutarieva NV, Tondii LD, et al. Effect of physical factors on bioelectric properties of cell nuclEI of buccal epithelium in students with chronic fatigue syndrome [J]. Lik Sprava,2005, (5-6):60-64.
54. Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease [J].Scand J Med Sci Sports,2006,16(1):53-63.
55. McCrone, et al. Cost-effectiveness of cognitive behavioural, graded exercise and usual care for patients with chronic fatigue in primary care [J].Psychol Med,2004,34: 991-999.
56.卓杰先,谷礼燕.循序渐进运动疗法治疗慢性疲劳综合征的相关研究[J].北京体育大学学报.2007.6：801-802.
57.赵燕.运动对慢性疲劳综合征大鼠神经免疫功能影响[J].中国公共卫生.2010,3：374-375.
58.Nijs J, De Meirleir K, Meeus M, et al. Chronic fatigue syndrome:intracellular immune regulations as a possible etiology for abnormal exercise response [J]. Med Hypotheses,2004,62(5):759-765.
59.杜国亮,张磊等.《黄帝内经》中相关“血气”“气血”论述辨析.辽宁中医药大学学报,2009,,11(3) ：13-14.
60.彭履祥.调气法的运用体会.中医专题讲座选(第二集).北京：人民卫生出版社,1981：205。
61.陈钢,盛昭园等.辨证治疗慢性疲劳综合征40例临床观察.江苏中医药,2011,43(3)：46-47.
62.王敏.慢性疲劳综合征的临床表现.中国社区医师,2003,19(17)：75,239.
63.吴峥嵘.中国医药辨证治疗慢性疲劳综合征.湖北中医杂志,2006,28(7)：22.
64.樊敏.慢性疲劳综合征的中医药诊疗现状浙江中西医结合杂志,2000,10(9)：575-576.
65.周立东.慢性疲劳证的中医病理生理学初探[J].中国病理生理杂志.1999,5(15)：13.
66.刘晓庄.中医药治疗慢性疲劳综合征评析.中医药研究1995,(3)：7-9.
67.胡兵,魏群利.慢性疲劳综合征辨治探要.安徽中医学院学报,2003,22(4)：1-3.
68.潘善余.慢性疲劳综合征的中医证治探讨.浙江中医杂志,2008,43(1)：29.
69.奚好君,史海霞.益气健脾法治疗慢性疲劳综合征50例.光明中医,2009,24(4)：754.
70.时学英.逍遥散治疗肝郁脾虚型慢性疲劳综合征的疗效及其对患者免疫功能的影响[J].浙江中医杂志,2007,42(7)：394-395
71.宫晶书,程金莲,王和天.滋补肝’肾汤治疗疲劳综合征的体会[J].首都医药,2004,(18)42-43.
72。陈兴华,黎璐茜,章闻,等.针刺治疗慢性疲劳综合征随机对照研究[J].中国针灸,2010,30(7)：533-536.
73.刘明,苏全德,郭芸倩。针灸治疗慢性疲劳综合征临床观察[J].现代中医药,2009,29(2)48-49.
74.王敬乔,周国平,刘小卫等.整体经络针刺法治疗慢性疲劳综合征的临床观察[J].湖南中医药大学学报,2010,30(9)：216-225
75.饶晓明,罗昭娜等.热敏灸治疗慢性疲劳综合征33例[J].江西中医药,2011,5(42)：66-67
76.兰彩虹.非瘢痕灸治疗慢性疲劳综合征的体会[J].贵阳中医学院学报,2011,33(1)：78-79.
77.陈秀玲,徐凯等.艾灸关元、气海穴治疗慢性疲劳综合征临床观察[J].新中医,2011,43(2)：109-110
78.刘长征,雷波.中医推拿治疗慢性疲劳综合征的随机对照研究[J].辽宁中医杂志,2012,37(2)：272-273.
79.卢文志,姜长利,周学礼等.足部按摩治疗慢性疲劳综合征[J].中国民间疗法,1996,(5)：34.
80.胡彩华,欧阳庆宜.平衡火罐治疗慢性疲劳综合征疗效观察[J].现代中西医结合杂志,2007,16(7)：935-936.
81.肖国民,周永芬等.华佗夹脊排罐法对慢性疲劳综合征患者生活质量的影响[J].西部中医药,2011,24(7)：86-87.
82.李丽英,穴位埋线治疗慢性疲劳综合征120例[J].中医外治杂志,2011,21(2)：45-46
83.杨才德,包金莲,宋建成.埋线和针灸治疗慢性疲劳综合征疗效的临床观察[J].医药卫生,2008,37(2)：186.
84.苗茂,阿古拉,何金柱.体针结合耳针贴压治疗慢性疲劳综合征64例[J].中国针,2005,25(4)： 292.
85.郭春媛,药物拔罐配合点刺放血治疗慢性疲劳综合征临床分析[J].实用中医药杂志,2007,23(6)：344-345.
86.匡调元.人体体质学-中医学个性化诊疗原理[M].上海：上海科学技术出版社.2003：137.
87.王琦.中医体质学[M].北京：中国医药科技出版社,1995.96-195.
88.刘淑萍.气虚体质研究的渊源及发展[J].内蒙古中医药.2001,12：92.
89.何裕民.体质研究—现时代中西医学的最佳交融点[J].医学与哲学,1996,17(6)：288.
90。清·陈复正辑订.幼幼集成.北京：人民卫生出版社,1988：4-68.
91.傅杰英,中医体质养生[M].鹭江出版社.2009：29.
92.匡调元.体质病理学研究[J].成都中医学院学报,1978,3(2)：3-17.
93.何裕民,刘文龙.新编中医基础理论[M].北京：北京医科大学中国协和医科大学联合出版社,1996：116-121.
94.中华中医药学会.中医体质分类与判定标准[J].世界中西医结合杂志,2009,4(4)：303.
95.何丽清,闫立,杨涛等.586例膝骨关节炎中医证型聚类分析与中医体质的关系[J].辽宁中医药大学学报.2012,14(07)：52-54.
96.万生芳.甘肃省高校教师亚健康人群中医体质类型调查与分析[J].甘肃中医学院学报.2012.29(3)：52-55
97.薛丽飞.老年抑郁症患者体质调查研究[J].北京中医药.2012,19(6)：5-6.
98.程兰,曹立幸,周霞.女性体质类型与子宫内膜异位症发病的相关性研究[J].辽宁中医杂志.2012,39 (2)0：30-302.
99.朱燕波,王琦等.中医体质类型与高血压的相关性研究[J].中西医结合学报,2010,8(1)：40-45
100.王娜娜,吴承玉.阳虚体质与病、证的相关性研究[J].南京中医药大学学报,2008,24(1)：4-5.
101.周昭辉,徐志锐,庄礼兴等.浅谈瘀血体质与中风病的防治[J].光明中医,2009,24(5)：792-794.
102.姜峰.季节性过敏性鼻炎患者中医体质特点研究[J].中国中医基础医学杂志,2007,13(9)：705-706.
103.姜峰.过敏性鼻炎与中医体质的关系[J].中华中医药杂志,2008,23(2)：140-141.
104.陈宝艳,李坤寅,曾蕾.从中医体质论治产后恶露不绝的临床研究[J].辽宁中医杂志.2012,39(4)：702-704.
105.王利平,王焕焕.补肾丸结合中医体质辨识治疗排卵障碍性不孕症临床观察[J].中医学报.2011,26(158)：877-878.
106.盛国光.中医体质学说与肝病临床辨治[J].光明中医,2008,23(3)：261-262.
107.匡调元,张伟荣,丁镛发.等.寒体与热体的研究[J].中医杂志.1995,,36(9)553-556.
108.骆斌,王琦.痰湿体质论析[J].安徽中医学院学报,1999,18(5)：10-11.
109.王睿林.气虚体质者外周血基因表达谱初步研究(D).北京：北京中医药大学.2005.
110.高洁,吕凤娟,林蒋海.中医痰湿体质与HLA-Ⅱ类基因相关性研究[J].陕西中医.2007,28(5)：622-624.
111.李英帅.阳虚、阴虚体质理论及代谢组学比较研究(D).北京：北京中医药大学,2009：56.
112.田栓磊.血瘀体质理论及其外周血基因表达谱的研究(D).北京：北京中医药大学.2009：49.
113.冯娜,贺娟,王琦.气郁体质相关差异基因研究[J].中国中西医结合杂志.2011,31(1)：48-51.
114.叶骞,叶平,李慧等.自然流产患者中医体质与凝血功能相关性的临床研究[J].浙江中医杂志.2012,47(])：24-25.
115.骆斌,张蓉,李峰.体质与慢性疲劳综合征的相关性研究[C].北京,第三届全国中医体质学术研讨会,2005：72-74。
116.张振贤,张烨,吴丽丽等.慢性疲劳综合征与中医体质及社会心理危险因素相关性调查[J].辽宁中医杂志.2011,38(1)：2226.
117.张振贤,吴丽丽,张烨等.慢性疲劳综合征的中医体质与证型研究[C].北京,人民大会堂中医治未病与亚健康高峰论坛暨首届亚健康经络调理学术研讨会,2009：46-54.
1. Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome:a comprehensive approach to its definition and study [J]. Ann Intern Med,1994,121(12):953959.
2.中华中医药学会.中医体质分类与判定[M].中国中医药出版社,2009.
3. Chalder T, Berelowitz G, Pawlikowska T, et al. Development of a fatigue scale [J]. J Psychosom Res,1993,37(2):147-153.
4. Watson D, Clark LA, Tel legen AlDevelopment and Validation of Brief Measures of Positive and Negative Affect:The PANAS ScaleslJournal of Personality and Social Psychology,1988; 54 (6):1063- 1070。
5.黄丽,杨廷忠,季忠民.正性负性情绪量表的中国人群适用性研究[J].中国心理卫生杂志,2003,171：54-56.
6.匡调元.人体体质学[M].上海：上海科学技术出版社.2003.8：225.
7.王琦.中医体质学.人民卫生出版社,2005,80-81.
8.张惠敏,郑守曾.气虚体质的研究进展[J].北京中医药大学学报,2004,27(1)：14-16.
9.潘宇政,陈业强,陈永斌,等.阴虚、阳虚、气虚证病人免疫功能的变化[J].广两医科大学学报,1999,2：16-18.
10.陈辉.中医气虚证的量化指标初探[J].中国中西医结合杂志,1998,18(7)：391.
11.王琦,姚实林,董静,等.阳虚体质者内分泌及免疫功能变化[J].中西医结合学报,2008,6(12)：1226-1232,
12.刘锐,杨世兴,乔成林,等.46例阳虚病人几种内分泌激素放射免疫测定的临床观察[J].陕西中医,1985,6(7)：30.
13.张家敬,郑敏.3H-TdR掺入法SAC诱导B淋转在SLE中医辨证中的意义[J].浙江中医杂志,1989,24(9)：417.
14.龚咏梅.职业女性的心理健康及调适[J].黑河学刊.2010,149(1)：57-58.
15.钱令嘉.应激与应激医学[J].疾病控制杂志.2003,7(5)：393-394
16.舒晓兵,廖建桥.工作压力研究：一个分析的框架[J].华中科技大学学报人文社会科学版.2002(5)：121-123.
17.陈浮芸.“治未病”思想认识近况[J].陕西中医学院学报,2007,30(6)：65-66.
18.王琦.中医体质三论[J].北京中医药大学学报.2008,31(10)：653-655.
1.胡春雨.浅谈脾胃与气虚体质的相关性[J].陕西中医.2006,7(6)：767-769.
2.王琦.论辨体论治的科学意义及其应用(二)[J].浙江中医药大学学报.2006,30(3)：220-224.
3.张新普,李敏,薛丹.阴虚体质易感疾病针灸调治规律探析[J].上海中医药大学学报,2012,26(6) ：30-32.
4.袁卓珺.王琦教授关于阳虚体质、阴虚体质的调体方法[J].中华中医药学刊.2012,30(10)：2187-2189.
5.刘立公,顾杰,刘婕等.古代文献中任脉及其腧穴主治的统计报告[J].针灸临床杂志.2010,26(4)： 6-8.
6.杨松堤,聂卉,孟凤仙.背俞穴临床应用与中医整体观[J].中医药学报,2000(6)：47.
7.曾芳,通调督脉治疗老年痴呆的理论探讨[J].四川中医.2004,22(9)：19-21.
8.刘立公,胡冬裴.古代文献中各类病证的常用经穴探讨[J].针灸临床杂志.2011,10(3)：67.
9.吴兴全,魏晓光,王之虹.固本培元手法治疗慢性疲劳综合征(脾。肾阳虚型)30例临床观察[J].长春中医药大学学报.2011,27(1)：91-92.
10.张伟,陈明人.失眠从膀胱经论治[J].江西中医学院学报.2011,23(4)：4-5.
11.刘立公,顾杰,沈雪勇等.古代文献中膀胱经及其腧穴主治的统计报告[J].上海针灸杂志.2004,23(]2)：42-43.
12.巍振义,张小黎.针刺原穴引起肢体温度变化的观察[J].针灸临床杂志,1995,11(4)：23.
13.王少军.井原穴皮温差的临床观察[J].辽宁中医杂志,1995,22(4)：178.
14.赵斌斌,李万瑶,络华亭.太白穴的临床功效[J].蜜蜂杂志.2009,2：31.
15.郁清琳.原穴证治规律的古代文献研究[D].广州：广州中医药大学,2012：31-33.
16.李婷,陈小兵.电针太白穴对实验性脾虚家兔的影响[J].中国中医药信息杂志,1999,6(5) ：25-26.
17.杨晓慧,张红石.针灸气海穴对小鼠抗疲劳、耐缺氧作用的影响[J].长春中医学院学报,2006.22(1)：68.
18.王维,李荣亨.针灸关元、气海穴对气虚证小鼠耐疲劳能力与免疫指标的影响[J],中国中医急症,2008,17(10)：1433-1434.
19.吴坤显,廖方正,曾红兵.针刺对实验性“。肾阳虚”、“。肾阴虚”动物病理组织形态的影响[J].河南中医,1998,4：20-21.
20.潘海燕,王永德,单秋华.电针太溪、阴谷对慢性肾脏病患者肾动脉血流的即刻效应[J].山东中医杂志,2008,27(5)：320-321.
21.姚红.肾虚证的针灸临床疗效观察[J].河南中医,1997,17(2)：111-112.
22.陈汉平,翟道荡,刘骏,等.艾灸“中脘”对小鼠S180,抑制作用的实验研究[J].江苏中医,1997,18(1)：27.
23.翟道荡,丁邦友,刘蓉,等.艾灸不同穴位调节ACTH、β-EP和免疫功能作用的研究[J].针刺研究,1996,21(2)：77.
24.王浩,申国明,汪克朋.电针中脘、胃俞对大鼠运动及血清胃动素、胃泌素水平的影响[J].安徽中医学院学报,2011,30(4)：37-39.
25.黄顺,王浩,黄学勇,等.电针胃俞募穴对胃扩张模型大鼠胃内压及血清胆囊收缩素-8、胃泌素水平的影响[J].安徽中医学院学报,2013,(1)：44-47.
26.王述菊,孙国杰,杜艳军,等.针刺对胃运动异常大鼠调节作用的神经机制研究[J].中国中医急症.2008(3)：352-353.
27.强肖文.调体在慢性疲劳综合症治疗中的临床疗效观察[D].广州：广州中医药大学,2011：16-19.
28.郑宁.温阳益气针灸方对治疗气虚质单纯性肥胖的研究[J].中国初级卫生保健,2012,8(9) ：92-93.
29.叶子怡,欧碧阳,林嬿钊,等.阳虚体质人群的健康评测特点分析[J].广州中医药大学学报,2010.27(4)：411-413.
30.李亚东,高洪泉、朱梅,等.针刺老年大鼠“足三里”“关元”穴对NO、SOD、MDA以及免疫影响的实验研究[J].中国针灸,2002,22(11)：121-122.
31.鲍毅梅,李汶阳,宋晓平.天灸关元、命门穴对佐剂性关节炎大鼠细胞免疫功能影响的比较研究[J].针灸临床杂志,2010,26(9)：54-56.
32.刘海燕.针灸调体治疗阳虚质痰瘀型痤疮的临床研究[D].广州：广州中医药大学.2011：24-25.
33.宋少军,李学玉,韩秀华,等.灸关元、大椎改善阳虚证血液流变指标的临床研究[J].辽宁中医杂志,2011,35(8)
34.王浩,申国明,黄顺,等电针胃俞募穴对大鼠胃运动及迷走背核复合体中胃动素和胃泌素表达的影响[J].安徽中医学院学报,2012,31(1)：27-29.
35.魏庆兴,菊地一搏,郑义弘,等.针灸预防大鼠应激性胃溃疡作用的实验研究[J].中国针灸,]997.17(10)：608.
36.王志成.艾灸治疗脾胃气虚型胃下垂30例[J].中国针灸,2006,,26(12)：895.
37.罗英华,罗伟君,唐纯志.针刺背俞穴对慢性疲劳大鼠氧化应激的影响[J].中医药导报,2012.18(6)：63-64.
38.樊云.推拿足三里。肾俞穴对阳虚模型大鼠CD4～+/CD8～+与IL-2影响的实验研究[D].湖北湖北中医学院,2005：19-21.
39.王英姿,刘小飞.艾灸结合穴位埋线调理阳虚体质[J].光明中医.2011,26(4)：758-759.
40.陈国远,向科明.微火针治疗肾阳虚证238例[J].中国针灸,2011,31(11)：1056.
41.靳勇,何冰.穴位敷贴在阳虚证中的临床应用[J].中国中医药现代远程教育,2010,8(10)：37.
42.刘立公,顾杰.古代文献中胃经及其腧穴主治的统计报告[J].上海针灸杂志.2003,22(4)：41-42.
43.何学斌,吴耀,罗济民,等.针灸对气虚大鼠红细胞免疫功能影响的实验研究[J].针剌研究,2003.28(3)：189-191.
44.冯春生.陈夏六君汤联合艾箱灸治疗脾胃气虚型功能性消化不良45例[J].中医研究,2012,6：62-63.
45.周俊亮,潘奔前,刘友章.穴位按摩改善气虚体质的临床研究[J].中医药临床杂志,2008,20(2)：130-131.
46.官星,董晓彤,王双昆,等.电针对阳虚大鼠神经内分泌系统的影响[J].中国中医基础医学杂志,2000,6(6)：57-60.
47.陈雄华,刘又香、王华,等.针灸“足三里”“关元”穴对阳虚大鼠免疫功能影响的比较研究[J].中国针灸,2000,9：43-45.
48.赵彩娇,范郁山,陆燕萍,等.艾灸“神阙”穴对肾阳虚家兔血清SOD的影响[J].中国针灸,2011.31(4)：342-346.
49.白桦,刘晓力,宋雅芳,等.脾肾阳虚证红细胞免疫功能改变的初步探讨[J].内蒙古中医药,1996,1：41.
50,廖运新,李金华.附子饼灸对老年人红细胞免疫功能的影响[J].湖南中医学院学报,1996,3(2)：24-25.
51.赵长信,赵昕,张惠华.针灸治疗阳虚证及对免疫功能的影响[J].中医杂志,1986,4：36.
52.贾跃进,王艳,刘琰,等.附子药饼穴位敷贴对阳虚体质的干预作用[J].河南中医,2011,31(9)：1043-1044.
53.何桂兰,袁申平,柯晓英.改良天灸法治疗慢性肾脏病肾阳虚证的临床研究[J].河北中医,2011,33(11)：1680-1682.
54.张日宏,张佩江.论体质与针刺调整作用的关系[J].河南中医,1991,11(65)：29-30.
55.袁萍,鲍春龄,袁莉等.五脏俞透刺治疗慢性疲劳综合征的临床观察[J].同济大学学报(医学版).2010,31(6)：102-104.
56.鲍春龄,袁萍,李立秋.阴阳气血配穴法针刺治疗慢性疲劳综合征临床观察[J].上海针灸杂志,2008,27,(6)：11-12.
57.王琦,姚实林,董静,等.阳虚体质者内分泌及免疫功能变化[J].中西医结合学报,2008,6(12)：1226-1232.
58.崔瑾,申定珠,熊芳丽.针灸膈俞对白细胞共同抗原及免疫功能的影响[J].四川中医,2006,24(2)：100-102.
59.李晓泓,韩毳,张露芬,等.艾灸(大椎)穴抗应激作用的实验研究[J].中国行为医学科学,2002,11(5)：495-497.
60.刘旭光,黄迪君,郝亮,等.艾灸对类风湿性关节炎大鼠下丘脑「垂体」肾上腺皮质轴的影响[J].中国中医基础医学杂志,2003,9(2)：57-59.
61.唐照亮,宋小鸽,李俊,等.艾灸抗炎免疫作用的实验观察与分析[J].针刺研究,1996,21(2)：67.
62.张永艳.脐灸疗法干预阳虚体质人群的疗效观察[J].针刺研究.2012,37(5)：409-411.
63.王芳.针灸改善阳虚体质治疗岭南痤疮的临床研究[D].广州：广州中医药大学,2010：28.
64.庞勇,李季,冯卓等.壮医药线点灸与雀啄灸对气虚质亚健康人群体质调养效果的比较[J]针灸临床杂志.2011,27(11).
65.伦新.实用针灸手法学[M].北京：人民卫生出版社,2004：481.
66.孙国杰.针灸学[M].北京：人民卫生出版社.2011,4：557.
67.崔小娜,庄礼兴,徐世芬.三伏天灸与三伏针剌对免疫学影响的对比研究[J].光明中医,2007,6：12-13.
68.曹晓慧.穴位敷贴治疗慢性肾脏病肾阳虚证、肾阴虚证的疗效观察[J].中国民族民间医药,2013,4：80-81.
69.关青,国生,付国兵.敷脐疗法对阳虚偏颇体质的干预研究[J].中国中医药信息杂志.2012,19(9)：79.
70.张永艳.脐灸疗法干预阳虚体质人群的疗效观察[J].针刺研究,2012,37(5)：409-411.
1. Fukuda K, Straus SE, Hickie], et al. The chronic fatigue syndrome:a comprehensive approach to its definition and study [J]. Ann Intern Med,1994,121(12):953959.
2.中华中医药学会.中医体质分类与判定[M].中国中医药出版社,2009.
3.王启才.针灸治疗学[M].北京：中国中医药出版社,2007.
4.郑筱萸.中药新药临床指导原则[M].北京：中国医药科技出版社,2002.
5. ChalderT, BerelowitzG,HerehisF. Development of a fatigue scale. Journal of Psvehosomatic researeh。Vo137(2),Feb 1993:37:147—153.
6.鲁明源.《内经》体质思想及应用——湿热体质与冠心病[D].山东：山东中医药大学,2001：20
7.匡调元.人体体质学——中医学个性化诊疗原理[M].上海：上海科学技术出版社,2003：171.
8.陈雪功.治病求本论析[J].安徽中医学院学报,2001,20(1)：5-7.
9.匡调元.人体体质学[M].上海：上海科学技术出版社,2003：219-220.
10.卢依平.辨体质——执简驭繁的临床辨证方法[J].中国中医药现代远程教育,2011,9(8)：114-115.
11.孙广仁.中医基础理论[M].北京：中国中医药出版社,2002,：298-300.
12.王琦.论中医体质研究的3个关键问题(下)[J].中医杂志,2006,,17(5)：330-332.
13.张蕾.中西医结合治疗慢性疲劳综合征[J].现代中西医结合杂志,2007,16(23)：3365.
14.欧阳崇志.浅谈体质因素在中医临床治疗上的应用[J].光明中医,2011,26(1)：11-12.