McLean Samuel A, Williams David A, Clauw Daniel J
Department of Emergency Medicine and The Chronic Pain and Fatigue Research Center, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
Traffic Inj Prev. 2005 Jun;6(2):97-104. doi: 10.1080/15389580580590931545.
Assess currently available evidence regarding the ability of a motor vehicle collision (MVC) to trigger the development of fibromyalgia (FM).
Consensus standards developed by the American College of Rheumatology Environmental Disease Study Group were used to assess the ability of an MVC to trigger FM.
Increasing evidence suggests that FM and related disorders are characterized by abnormalities in central nervous system function related to sensory processing, autonomic regulation, and neuroendocrine function. MVC trauma appears capable of triggering FM, but generally not through direct biomechanical injury. Instead, the evidence suggests that MVC trauma can act as a "stressor," which in concert with other factors, such as an individual's biologic vulnerability, psychosocial factors, cultural factors, and so on, may result in the development of chronic widespread pain and other somatic symptoms. MVC trauma is only one of many stressors which can trigger such disorders, and the environment within which the stressor is experienced (biological and psychosocial) may largely determine whether there is an adverse physiologic result or not.
The evidence that MVC trauma may trigger FM meets established criteria for determining causality, and has a number of important implications, both for patient care, and for research into the pathophysiology and treatment of these disorders.
评估目前关于机动车碰撞（MVC）引发纤维肌痛（FM）的现有证据。
采用美国风湿病学会环境疾病研究小组制定的共识标准来评估MVC引发FM的能力。
越来越多的证据表明，FM及相关疾病的特征是与感觉处理、自主调节和神经内分泌功能相关的中枢神经系统功能异常。MVC创伤似乎能够引发FM，但通常并非通过直接的生物力学损伤。相反，证据表明MVC创伤可作为一种“应激源”，与其他因素（如个体的生物易感性、心理社会因素、文化因素等）共同作用，可能导致慢性广泛性疼痛和其他躯体症状的出现。MVC创伤只是众多可引发此类疾病的应激源之一，而应激源发生时所处的环境（生物和心理社会环境）在很大程度上可能决定是否会产生不良生理结果。
MVC创伤可能引发FM的证据符合确定因果关系的既定标准，并且对患者护理以及这些疾病的病理生理学和治疗研究都具有许多重要意义。
