Buskila D
Ben Gurion University of the Negev, Faculty of Health Sciences, Soroka Medical Center, Beer Sheva, Israel.
Curr Opin Rheumatol. 2000 Mar;12(2):113-23. doi: 10.1097/00002281-200003000-00005.
Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.
纤维肌痛和广泛性疼痛在被转诊至风湿病诊所的患有无法解释疾病的海湾战争退伍军人中很常见。与正常月经周期的女性相比，在月经周期的经后期，压痛增加，但口服避孕药使用者中未出现这种情况。纤维肌痛患者具有高水平的症状，这些症状曾被用于定义与硅胶植入物相关的综合征。压痛点被发现是与急性传染性单核细胞增多症相关的常见短暂表现，但纤维肌痛是一种不常见的长期结果。进一步探讨了纤维肌痛与其他风湿性和全身性疾病的常见关联。一项初步研究揭示了纤维肌痛与HLA区域之间可能存在联系。发现纤维肌痛患者激活下丘脑 - 垂体 - 肾上腺轴的下丘脑 - 垂体部分以及交感 - 肾上腺系统的能力受损，导致促肾上腺皮质激素和肾上腺素对低血糖的反应降低。文献中对自主神经功能障碍在慢性疲劳综合征中疲劳及其他症状的发生或加重中可能起的作用表达了很多兴趣。在慢性疲劳综合征患者中通过聚合酶链反应检测到支原体属和发酵支原体。据报道，肌筋膜性颞下颌关节紊乱不会在家族中遗传。过去一年没有关于纤维肌痛、慢性疲劳综合征或肌筋膜疼痛综合征的重大治疗试验报告。强调了认知行为疗法和行为疗法对成人慢性疼痛的有效性。报告了儿童和青少年纤维肌痛和慢性疲劳综合征的良好预后。
