Crofford L J, Appleton B E
University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI, 48109-0680, USA.
Curr Rheumatol Rep. 2001 Apr;3(2):147-56. doi: 10.1007/s11926-001-0010-9.
Fibromyalgia (FM) is a syndrome of chronic widespread musculoskeletal pain that is accompanied by sleep disturbance and fatigue. Clinical treatment usually includes lifestyle modifications and pharmacologic interventions meant to relieve pain, improve sleep quality, and treat mood disorders. These therapies are often ineffective or have been shown in clinical studies to have only short-term effectiveness. Pharmacologic treatments have considerable side effects. Patients may have difficulty complying with exercise-based treatments. Thus, patients seek alternative therapeutic approaches and physicians are routinely asked for advice about these treatments. This article reviews nontraditional treatment alternatives, from use of nutritional and herbal supplements to acupuncture and mind-body therapy. Little is known about efficacy and tolerance of complementary and alternative therapies in FM and other chronic musculoskeletal pain syndromes. Most studies on these treatments have been performed for osteoarthritis, rheumatoid arthritis, or focal musculoskeletal conditions. Clinical trials are scarce; the quality of these trials is often criticized because of small study population size, lack of appropriate control interventions, poor compliance, or short duration of follow-up. However, because of widespread and growing use of alternative medicine, especially by persons with chronic illnesses, it is essential to review efficacy and adverse effects of complementary and alternative therapies.
纤维肌痛（FM）是一种慢性广泛性肌肉骨骼疼痛综合征，伴有睡眠障碍和疲劳。临床治疗通常包括生活方式的改变和旨在缓解疼痛、改善睡眠质量以及治疗情绪障碍的药物干预。这些疗法往往无效，或者在临床研究中显示仅具有短期疗效。药物治疗有相当多的副作用。患者可能难以坚持基于运动的治疗方法。因此，患者寻求替代治疗方法，医生也经常被问及这些治疗方法的建议。本文综述了非传统的治疗选择，从使用营养和草药补充剂到针灸和身心疗法。关于补充和替代疗法在纤维肌痛及其他慢性肌肉骨骼疼痛综合征中的疗效和耐受性知之甚少。大多数关于这些治疗的研究是针对骨关节炎、类风湿关节炎或局部肌肉骨骼疾病进行的。临床试验很少；这些试验的质量经常受到批评，原因包括研究人群规模小、缺乏适当的对照干预、依从性差或随访时间短。然而，由于替代医学的广泛和日益增加的使用，尤其是慢性病患者，审查补充和替代疗法的疗效和不良反应至关重要。
