Brückle W, Zeidler H
Rheumaklinik, Bad Nenndorf.
Internist (Berl). 2005 Nov;46(11):1188-97. doi: 10.1007/s00108-005-1497-3.
Fibromyalgia is a common syndrome of unknown etiology characterized by chronic widespread pain and poly-symptomatic autonomic disturbances and often mental features. The American College of Rheumatology's classification criteria define fibromyalgia by widespread pain and 11 of 18 tender points. Fibromyalgia is a diagnosis of exclusion as long as stand none laboratory or technical tests. The major role in pathogenesis appears to be central and involves the subcortical pain modulation, psychical stress especially in early childhood, endocrinological and genetic factors. There is no evidence of abnormalities in muscle and tendon. The goal of therapy in fibromyalgia is pain, reduced physical function and sleep disturbance. Actual evidence of effects of pharmacological and nonpharmacological interventions are summarized. Tricyclic agents, aerobic exercises, patient education and combined therapies can reduce effectively symptoms and disability.
纤维肌痛是一种病因不明的常见综合征，其特征为慢性广泛性疼痛、多症状自主神经功能紊乱，且常伴有精神症状。美国风湿病学会的分类标准通过广泛性疼痛和18个压痛点中的11个来定义纤维肌痛。纤维肌痛是一种排除性诊断，因为目前尚无实验室或技术检查能确诊。其发病机制的主要作用似乎是中枢性的，涉及皮层下疼痛调节、心理压力，尤其是童年早期的心理压力、内分泌和遗传因素。没有证据表明肌肉和肌腱存在异常。纤维肌痛的治疗目标是缓解疼痛、改善身体功能和睡眠障碍。本文总结了药物和非药物干预效果的实际证据。三环类药物、有氧运动、患者教育及联合治疗可有效减轻症状和残疾程度。
