Millea P J, Holloway R L
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
Am Fam Physician. 2000 Oct 1;62(7):1575-82, 1587.
Fibromyalgia is an extremely common chronic condition that can be challenging to manage. Although the etiology remains unclear, characteristic alterations in the pattern of sleep and changes in neuroendocrine transmitters such as serotonin, substance P, growth hormone and cortisol suggest that dysregulation of the autonomic and neuroendocrine system appears to be the basis of the syndrome. The diagnosis is clinical and is characterized by widespread pain, tender points and, commonly, comorbid conditions such as chronic fatigue, insomnia and depression. Treatment is largely empiric, although experience and small clinical studies have proved the efficacy of low-dose antidepressant therapy and exercise. Other less well-studied measures, such as acupuncture, also appear to be helpful. Management relies heavily on the physician's supportive counseling skills and willingness to try novel strategies in refractory cases.
纤维肌痛是一种极为常见的慢性疾病，其治疗颇具挑战性。尽管病因尚不明确，但睡眠模式的特征性改变以及血清素、P物质、生长激素和皮质醇等神经内分泌递质的变化表明，自主神经系统和神经内分泌系统的失调似乎是该综合征的基础。诊断基于临床症状，其特征为广泛疼痛、压痛点，且通常伴有慢性疲劳、失眠和抑郁等合并症。治疗主要基于经验，不过经验及小型临床研究已证实低剂量抗抑郁治疗和运动的有效性。其他研究较少的措施，如针灸，似乎也有帮助。管理在很大程度上依赖医生的支持性咨询技巧以及在难治性病例中尝试新策略的意愿。
