Abstract: Medically unexplained symptoms（MUS）have become an important public health issue. The biomedical interpretation of MUS cannot solve lots of dilemma faced by MUS individuals，and the problems of overdiagnosis and overtreatment are clinically prominent. Starting from the explanatory model of MUS based on narrative medicine，this article proposes that the vast majority of patients with MUS suffer from traumatic，suspicious，professional or elderly narrative foreclosures or interpersonal narrative disruption. Only general practitioners or specialists with narrative thinking can reduce overdiagnosis and its negative effects，and improve patients' life quality. Healthcare professionals may actively guide patients to carry out narrative adjustment and narrative mediation on the basis of establishing a good narrative connection with persons with MUS，so as to help them achieve leapfrog growth in their narrating self and reduce the impact of symptoms on their quality of life. The article calls for establishing a system of narrative medicine to improve the professional narrative competencies of general practitioners and integrate narrative scales for narrative disconnectedness as well as narrative foreclosure into the process of holistic diagnosis and healing for MUS，in order to effectively improve their capabilities of narrative diagnosis，narrative patient education and narrative healing in dealing with MUS.

Key words: Narrative medicine, Medically unexplained symptoms, Clinicians' narrative competencies, Holistic healing

摘要： “医学无法解释症状”（MUS）已成为重要的公共健康问题，MUS的生物医学阐释方式无法解决MUS个体面临的诸多困境，临床上，过度诊断及过度治疗问题突出。本文从MUS的叙事医学阐释模式出发，提出绝大多数MUS个体皆为创伤型、疑虑型或老年型叙事闭锁者或者人际叙事断裂者，唯有具备叙事思维的全科或专科医生能减少对MUS的过度治疗及其带来的负面效应，同时提升患者生命质量。医者应在主动与MUS个体建立良好叙事连接的基础上，引导患者积极展开叙事调节，助其实现叙事自我的跨越式成长，减少症状对其生命质量的影响。文章呼吁构建全科叙事医学体系，提升全科医生职业叙事能力，将叙事连接断裂和叙事闭锁状况量表融入MUS诊治过程，有效提升其应对“医学难以解释症状”的叙事诊断、叙事患教与叙事疗愈能力。

关键词: 叙事医学, 医学无法解释的症状, 医者叙事思维, 全人疗愈