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[纤维肌痛综合征:康复与管理的新视角。综述]

[Fibromyalgic syndrome: new perspectives in rehabilitation and management. A review].

作者信息

Melillo N, Corrado A, Quarta L, D'Onofrio F, Trotta A, Cantatore F P

机构信息

Clinica Reumatologica Mario Carrozzo, Università degli Studi di Foggia, Foggia.

出版信息

Minerva Med. 2005 Dec;96(6):417-23.

Abstract

Fibromyalgia is a chronic syndrome, characterized by widespread body pain and pain at specific tender points, whose etiology and pathogenesis is still unknown. Patient can also exhibit a range of other symptoms including irritable bowel syndrome, chest pain, anxiety, fatigue, sleep disturbance, headache. The prevalence of fibromyalgia ranges from 1-3% in the general population, and the condition is more common among female than males. Contrary to the situation a few years ago, the most widely accepted hypothesis now evoke central nervous system mechanisms, whose local functions could influence also periferical microvascular activity at tender points. There are many findings supporting the hypothesis of different endogenic and exogenic factors that lead to chronic local hypoxia in muscle tissue. Currently, therapy is polipragmatic and is aimed at reducing the pain. A range of medical treatment had been used to treat fibromyalgia. Pharmacological therapy aims to enhance the pain threshold and to support sleep. Nonpharmaceutical treatment modalities, such as exercise, massage, idrotherapy can be helpful. Future studies should investigate the possible benefits of new strategies that may combine the effects of hot pool water, stretching exercises, massage and relaxation benefits of balneotherapy.

摘要

纤维肌痛是一种慢性综合征,其特征为全身广泛疼痛以及特定压痛点疼痛,其病因和发病机制尚不清楚。患者还可能出现一系列其他症状,包括肠易激综合征、胸痛、焦虑、疲劳、睡眠障碍、头痛。纤维肌痛在普通人群中的患病率为1%至3%,女性比男性更为常见。与几年前的情况相反,目前最广泛接受的假说是中枢神经系统机制,其局部功能也可能影响压痛点处的外周微血管活动。有许多研究结果支持不同的内源性和外源性因素导致肌肉组织慢性局部缺氧这一假说。目前,治疗方法是多方面的,旨在减轻疼痛。已经使用了一系列医学治疗方法来治疗纤维肌痛。药物治疗旨在提高痛阈并促进睡眠。非药物治疗方式,如运动、按摩、水疗可能会有帮助。未来的研究应调查新策略可能带来的益处,这些新策略可能结合热水池的水、伸展运动、按摩以及浴疗法的放松效果。

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