慢性疲劳综合征（chronic fatigue syndrome，CFS）以持续性疲劳为核心症状，常伴有认知障碍、疼痛、睡眠及情绪异常，其病理机制涉及遗传、感染、菌群失调、免疫炎症紊乱、氧化应激及代谢异常等多因素交互作用，临床缺乏特异性诊断标志物及有效治疗手段，已成为重大公共卫生挑战。中医将其归属于“虚劳”“虚损”范畴，认为其核心病机在于脾肾两虚，气化失司。脾虚则运化失职，气血匮乏，四肢失养而倦怠；肾虚则精亏髓减，元气衰惫，致脑力不济、筋骨痿弱。脾肾互损，气化无权，水湿内停，进一步加重虚损。纵览古今，中医药治疗CFS的医案并不鲜见，其整体观念与辨证论治的学术内涵，契合CFS多靶点、多通路的复杂病理特点。故针对CFS的中西医病因病机进行系统梳理，综述中医药和现代医学在CFS治疗中的应用，为CFS的临床治疗及学术科研提供思路。

Chronic fatigue syndrome (CFS) is characterized by persistent fatigue as its core symptom, often accompanied by cognitive impairment, pain, sleep disturbances, and emotional abnormalities. Its pathophysiology involves the interplay of multiple factors including genetics, infection, dysbiosis, immune-inflammatory dysregulation, oxidative stress, and metabolic abnormalities. Clinically, the lack of specific diagnostic markers and effective treatment options have made CFS a significant public health challenge. Traditional Chinese medicine (TCM) classifies it under the categories of “consumptive disease” and “deficiency syndrome”. The core pathogenesis is attributed to dual deficiency of the spleen and kidney, leading to impaired qi transformation. Spleen deficiency results in inadequate transportation and transformation, causing deficiency of qi and blood, which in turn fails to nourish the limbs, leading to fatigue. Kidney deficiency manifests as depletion of essence and marrow, resulting in exhaustion of primordial energy, causing mental fatigue and weakness of tendons and bones. Mutual impairment of spleen and kidney disrupts qi transformation, causing internal retention of water and dampness, which further exacerbates deficiency. Throughout history, TCM case studies addressing CFS are not uncommon. Its holistic perspective and syndrome differentiation approach align with CFS’s complex, multi-targeted, and multi-pathway pathology. This study therefore systematically reviews the etiology and pathogenesis of CFS from both TCM and Western medical perspectives, summarizing the applications of both traditional and modern medicine in CFS treatment to provide insights for clinical management and academic research.

R285

国家自然科学基金资助项目（82474312）；北京薪火传承3＋3项目（2023-SZ-A51）