Auquier L, Bontoux D, Löo H, Godeau P, Menkès C-J, Paolaggi J-B, Perrot S
Rev Med Interne. 2008 Feb;29(2):161-8. doi: 10.1016/j.revmed.2007.08.004. Epub 2007 Sep 21.
We review the current knowledge about fibromyalgia, adding to the clinical aspects, the nosology, epidemiology and pathogenesis. The therapeutic and social management of these suffering patients are discussed.
The limitations of the American College of Rheumatology classification criteria used as diagnostic criteria are discussed. Fibromyalgia is not a simple psychiatric disorder, even if psychiatric symptoms are constantly found. Based on functional brain imaging, there is some evidence pointing to an abnormal function of the supra-spinal centres for pain regulation.
Fibromyalgia is a clinical autonomous entity. Physiopathology knowledge is improving, but must be confirmed by new research. Patients will take profit of multimodal individualized treatment programs, including explanations about the diagnosis. In most cases, fibromyalgia is compatible with the maintenance of a professional activity, possibly adapted to the patient. Recognized disability requiring compensation is infrequent.
我们回顾了关于纤维肌痛的现有知识,涵盖临床方面、疾病分类学、流行病学和发病机制,并讨论了这些患者的治疗和社会管理。
讨论了美国风湿病学会用作诊断标准的分类标准的局限性。纤维肌痛并非简单的精神障碍,即便经常发现精神症状。基于功能性脑成像,有一些证据表明脊髓上疼痛调节中枢功能异常。
纤维肌痛是一种临床独立实体。病理生理学知识正在不断完善,但需新研究加以证实。患者将受益于多模式个体化治疗方案,包括对诊断的解释。在大多数情况下,纤维肌痛患者可以维持职业活动,可能需要根据患者情况进行调整。需要赔偿的公认残疾情况并不常见。