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功能性胃肠病（FGIDs）常呈现症状重叠，可同时表现出上下消化道多种不适，增加诊疗难度。中医药以整体观和辨证论治为核心，通过以证统病、异病同治整合复杂症状，在FGIDs症状重叠中展现独特优势。近年来相关研究在中医病因病机阐释、证候分布规律及临床疗效评价等方面取得进展。现有研究对FGIDs症状重叠的病因病机核心观点集中在脾胃虚弱、肝郁气滞、气机失调及形神失和等方面，围绕FGIDs症状重叠的中医药治疗研究涉及药物主要集中于中药复方、中西药联合应用及中医外治法等，但研究数量较少，存在样本量小、循证证据不足及疗效评价不规范等问题。提出FGIDs症状重叠中医诊疗策略为异病同治的整体观诊疗、辨证论治的个体化诊疗及生物-社会-心理的诊疗模式。未来应加强共性病理机制解析，推进中药复方疗效与作用机制研究，建立规范化、多维度的疗效评价体系，并借助组学与人工智能揭示中医药整体调节的科学依据。
Abstract：Functional gastrointestinal disorders(FGIDs) commonly present with overlapping symptoms, which may simultaneously involve multiple discomforts of the upper and lower gastrointestinal tract, thereby increasing the difficulty of diagnosis and treatment. Centered on a holistic view and syndrome differentiation and treatment, traditional Chinese medicine(TCM) demonstrates unique advantages in managing symptom overlap in FGIDs by using syndromes to unify diseases and applying the principle of treating different diseases with the same therapeutic approach to integrate complex symptom presentations. In recent years, progress has been made in related research on the elucidation of TCM etiology and pathogenesis, patterns of syndrome distribution, and evaluation of clinical efficacy. Existing studies generally agree that the core etiological and pathogenetic mechanisms of symptom overlap in FGIDs involve spleen-stomach deficiency, liver qi stagnation, dysregulation of qi dynamics, and disharmony between form and spirit. TCM treatment studies for symptom overlap in FGIDs have mainly focused on Chinese herbal compound formulas, combined use of Chinese and western medicines, and external TCM therapies. However, the overall number of studies remains limited, with issues such as small sample sizes, insufficient evidence-based support, and non-standardized efficacy evaluation. It is proposed that TCM diagnostic and therapeutic strategies for symptom overlap in FGIDs should include a holistic approach based on treating different diseases with the same method, individualized treatment guided by syndrome differentiation, and a bio-psycho-social medical model. Future research should strengthen investigations into shared pathological mechanisms, advance studies on the efficacy and mechanisms of Chinese herbal compound formulas, establish standardized and multidimensional efficacy evaluation systems, and leverage omics technologies and artificial intelligence to elucidate the scientific basis of the holistic regulatory effects of TCM.
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基本信息:
DOI：10.13288/j.11-2166/r.2026.03.007
中图分类号:R259
引用信息:
[1]王凤云,张北华,柯晓,等.功能性胃肠病症状重叠的中医诊疗现状、策略与展望[J].中医杂志,2026,67(03):264-270.DOI:10.13288/j.11-2166/r.2026.03.007.
基金信息:
中国科学技术协会2024年中医脾胃病学学科发展研究（2024XKFZYJ）; 国家自然科学基金（82174363）; 中国中医科学院科技创新工程创新团队（CI2021B005）;中国中医科学院科技创新工程重点项目（CI2021A01001）