Martinez-Lavin Manuel, Infante Oscar, Lerma Claudia
National Institute of Cardiology, Mexico City, Mexico.
Semin Arthritis Rheum. 2008 Feb;37(4):260-4. doi: 10.1016/j.semarthrit.2007.04.003. Epub 2007 Jun 14.
Modern clinicians are often frustrated by their inability to understand fibromyalgia and similar maladies since these illnesses cannot be explained by the prevailing linear-reductionist medical paradigm.
This article proposes that new concepts derived from the Complexity Theory may help understand the pathogenesis of fibromyalgia, chronic fatigue syndrome, and Gulf War syndrome.
This hypothesis is based on the recent recognition of chaos fractals and complex systems in human physiology.
These nonlinear dynamics concepts offer a different perspective to the notion of homeostasis and disease. They propose that the essence of disease is dysfunction and not structural damage. Studies using novel nonlinear instruments have shown that fibromyalgia and similar maladies may be caused by the degraded performance of our main complex adaptive system. This dysfunction explains the multifaceted manifestations of these entities.
To understand and alleviate the suffering associated with these complex illnesses, a paradigm shift from reductionism to holism based on the Complexity Theory is suggested. This shift perceives health as resilient adaptation and some chronic illnesses as rigid dysfunction.
现代临床医生常常因无法理解纤维肌痛及类似病症而感到沮丧,因为这些疾病无法用当前盛行的线性还原论医学范式来解释。
本文提出,源自复杂性理论的新概念可能有助于理解纤维肌痛、慢性疲劳综合征和海湾战争综合征的发病机制。
这一假说基于近期对人体生理学中混沌分形和复杂系统的认识。
这些非线性动力学概念为稳态和疾病的概念提供了不同的视角。它们提出疾病的本质是功能障碍而非结构损伤。使用新型非线性仪器的研究表明,纤维肌痛及类似病症可能是由我们主要的复杂适应系统性能退化所致。这种功能障碍解释了这些病症的多方面表现。
为了理解并减轻与这些复杂疾病相关的痛苦,建议从基于还原论的范式转向基于复杂性理论的整体论范式。这种转变将健康视为有弹性的适应,而将一些慢性疾病视为僵化的功能障碍。