Lucas H J, Brauch C M, Settas L, Theoharides T C
Special Clinic for FMS and CFS, Trier, Germany.
Int J Immunopathol Pharmacol. 2006 Jan-Mar;19(1):5-10.
Fibromyalgia (FMS) is a debilitating disorder characterized by chronic diffuse muscle pain, fatigue, sleep disturbance, depression and skin sensitivity. There are no genetic or biochemical markers and patients often present with other comorbid diseases, such as migraines, interstitial cystitis and irritable bowel syndrome. Diagnosis includes the presence of 11/18 trigger points, but many patients with early symptoms might not fit this definition. Pathogenesis is still unknown, but there has been evidence of increased corticotropin-releasing hormone (CRH) and substance P (SP) in the CSF of FMS patients, as well as increased SP, IL-6 and IL-8 in their serum. Increased numbers of activated mast cells were also noted in skin biopsies. The hypothesis is put forward that FMS is a neuro-immunoendocrine disorder where increased release of CRH and SP from neurons in specific muscle sites triggers local mast cells to release proinflammatory and neurosensitizing molecules. There is no curative treatment although low doses of tricyclic antidepressants and the serotonin-3 receptor antagonist tropisetron, are helpful. Recent nutraceutical formulations containing the natural anti-inflammatory and mast cell inhibitory flavonoid quercetin hold promise since they can be used together with other treatment modalities.
纤维肌痛（FMS）是一种使人衰弱的病症，其特征为慢性弥漫性肌肉疼痛、疲劳、睡眠障碍、抑郁和皮肤敏感。目前尚无遗传或生化标志物，且患者常伴有其他合并症，如偏头痛、间质性膀胱炎和肠易激综合征。诊断包括存在11/18个触发点，但许多有早期症状的患者可能不符合这一定义。发病机制尚不清楚，但有证据表明FMS患者脑脊液中促肾上腺皮质激素释放激素（CRH）和P物质（SP）增加，血清中SP、白细胞介素-6（IL-6）和白细胞介素-8也增加。皮肤活检中还发现活化肥大细胞数量增加。有人提出假说，认为FMS是一种神经免疫内分泌疾病，特定肌肉部位神经元释放的CRH和SP增加会触发局部肥大细胞释放促炎和神经致敏分子。尽管低剂量三环类抗抑郁药和5-羟色胺-3受体拮抗剂托烷司琼有帮助，但目前尚无治愈性治疗方法。最近含有天然抗炎和肥大细胞抑制黄酮类化合物槲皮素的营养制剂有前景，因为它们可与其他治疗方式联合使用。
