Peterson Erin L
United States Air Force, Aviano Air Base, Italy.
J Am Acad Nurse Pract. 2007 Jul;19(7):341-8. doi: 10.1111/j.1745-7599.2007.00235.x.
The purpose of this article is to review (a) what is currently known about the pathophysiology of fibromyalgia (FM), (b) how to identify patients who are susceptible to this disorder, and (c) the recommended pharmacological and nonpharmacological treatment options.
Data sources include reviews and original research from scholarly journals and Internet sites.
There are approximately 6 million individuals in the United States diagnosed with FM, making it the third most prevalent rheumatologic disorder in this country. Failure to identify a specific causal mechanism for FM has resulted in a shift in the focus of research from etiology to treatment (Baumstark & Buckelew, 2002). Based on the literature, the most successful interventions for reduction of chronic symptoms in the FM patient is a combination of education, psychological assistance, and exercise, along with medications. It is essential that nurse practitioners (NPs) understand the issues and concerns of patients afflicted with this complex disorder. Although the organic etiology of FM syndrome remains unclear, the goals of treatment are to control pain and improve adjustment, well-being, and daily functioning of these patients to the maximum extent possible.
NPs are in a unique position to help identify patients who may be suffering from FM or those diagnosed with FM reporting inadequate relief of symptoms. The incomplete understanding of the biological underpinnings, as well as the multiple symptoms that characterize FM syndrome, make it a challenging disorder to diagnose and treat. It takes time and patience to care for FM patients, and there are no "quick fixes." Diagnosis is made by a combination of patient history, physical examination, laboratory evaluations, and exclusion of other causes of symptoms confused with FM. Understanding the symptomology and recommended treatments will allow NPs to give appropriate care that may include making referrals for multidisciplinary treatment of these complex patients.
本文旨在综述以下内容：（a）目前已知的纤维肌痛（FM）病理生理学；（b）如何识别易患该疾病的患者；（c）推荐的药物和非药物治疗方案。
数据来源包括学术期刊和互联网网站的综述及原创研究。
在美国，约有600万人被诊断患有FM，使其成为该国第三大最常见的风湿性疾病。由于未能确定FM的具体病因机制，研究重点已从病因学转向治疗（鲍姆施塔克和布克勒，2002年）。根据文献，对FM患者减轻慢性症状最成功的干预措施是教育、心理援助、运动以及药物治疗相结合。执业护士（NP）必须了解患有这种复杂疾病的患者的问题和担忧。尽管FM综合征的器质性病因仍不清楚，但治疗目标是尽可能最大程度地控制疼痛，改善这些患者的适应能力、幸福感和日常功能。
NP处于独特地位，能够帮助识别可能患有FM的患者或那些被诊断患有FM但症状缓解不足的患者。对生物学基础的不完全理解以及FM综合征的多种症状，使其成为一种难以诊断和治疗的疾病。护理FM患者需要时间和耐心，没有“快速解决”的办法。通过结合患者病史、体格检查、实验室评估以及排除与FM混淆的其他症状原因来进行诊断。了解症状学和推荐的治疗方法将使NP能够提供适当的护理，这可能包括为这些复杂患者进行多学科治疗的转诊。
