中医治疗格林巴利综合征的研究进展

Research Progress on Traditional Chinese Medicine Treatment for Guillain-Barré Syndrome

摘要: 格林巴利综合征(GBS)属中医“痿证”范畴，其核心病机以脾胃虚弱为本，外邪、湿热、瘀血、痰浊为标，病位在脾胃，常累及肝肾及肺。现代医家辨证分型涵盖肺燥津伤、湿热浸淫、寒湿痹阻、脾胃虚弱、肝肾亏虚等证型。治疗上，内治法注重健脾益气、滋补肝肾、清热祛湿、活血通络，常用补中益气汤、黄芪桂枝五物汤、四妙散等方剂；外治法以针刺为核心，遵循“治痿独取阳明”原则，常配合通督调神针法、电针及灸法。针药结合的综合疗法在改善肌力、神经电生理指标及调节免疫方面优势显著。然而，当前研究存在辨证规范不统一、高质量随机对照试验不足及机制研究欠缺等问题。未来需统一辨证标准，开展更多高质量临床研究及基础实验，以进一步挖掘中医药治疗GBS的潜力，为这一难治性疾病提供更有效、安全的干预方案。

Abstract: Guillain-Barré syndrome (GBS) is classified under “Flaccidity Syndrome” (Wei Zheng) in traditional Chinese medicine (TCM). Its core pathogenesis is rooted in spleen-stomach deficiency as the primary cause, with external pathogens, damp-heat, blood stasis, and phlegm turbidity as secondary factors. The disease involves the spleen and stomach, often affecting the liver, kidney, and lung. Syndrome differentiation includes lung dryness with fluid damage, damp-heat immersion, cold-dampness obstruction, spleen-stomach deficiency, and liver-kidney deficiency. Internal treatments focus on strengthening the spleen and benefiting qi, nourishing the liver and kidney, clearing heat and removing dampness, and activating blood circulation, using formulas such as Buzhong Yiqi Decoction, Huangqi Guizhi Wuwu Decoction, and Simiao Powder. Acupuncture is the core external therapy, following the principle of “treating flaccidity by selecting Yangming meridians alone,” often combined with Du-meridian-regulating needling, electroacupuncture, and moxibustion. Combined acupuncture-medicine therapy shows advantages in improving muscle strength, neurophysiological parameters, and immune regulation. However, current research faces issues such as non-standardized syndrome differentiation, insufficient high-quality randomized controlled trials, and a lack of mechanistic studies. Future efforts should standardize diagnostic criteria and conduct more high-quality clinical and basic research to further explore TCM’s potential in treating GBS, providing more effective and safer interventions for this refractory disease.