Sommer C, Häuser W, Berliner M, Brückle W, Ehlers S, Mönkemöller K, Moradi B, Petzke F, Uçeyler N, Wörz R, Winter E, Nutzinger D O
Neurologische Klinik, Universität Würzburg, Würzburg.
Schmerz. 2008 Jun;22(3):313-23. doi: 10.1007/s00482-008-0676-2.
An interdisciplinary guideline for the treatment of fibromyalgia syndrome (FMS) and chronic widespread pain (CWP) was developed in cooperation with ten German medical and psychological associations and two patients' self-help organizations.
Using the Cochrane Collaboration Reviews (1993-12/2006), Medline (1980-2006), PsychInfo (1966-12/2006), and Scopus (1980-12/ 2006) a systematic literature search was performed, which included all randomised controlled trials (RCT) evaluating multicomponent therapy in FMS and CWP. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. The strength of recommendation was graded according to the German program for disease management guidelines. Consensus was achieved using a multi-step nominal group procedure.
The short-term use of amitriptyline is strongly recommended (grade A) and the short-term use of fluoxetine und duloxetine is recommended (grade B).
The recommendations regarding pharmacological treatment of FMS are limited by the short duration of the RCT, the lack of follow-ups and absence of cost-effectiveness studies.
与德国十个医学和心理学协会以及两个患者自助组织合作制定了纤维肌痛综合征（FMS）和慢性广泛性疼痛（CWP）的跨学科治疗指南。
利用Cochrane协作评价（1993年 - 2006年12月）、Medline（1980年 - 2006年）、PsychInfo（1966年 - 2006年12月）和Scopus（1980年 - 2006年12月）进行了系统的文献检索，其中包括所有评估FMS和CWP多成分治疗的随机对照试验（RCT）。根据牛津循证医学中心的分类系统确定证据水平。推荐强度根据德国疾病管理指南计划进行分级。通过多步骤名义群体程序达成共识。
强烈推荐短期使用阿米替林（A级），推荐短期使用氟西汀和度洛西汀（B级）。
关于FMS药物治疗的建议受到RCT持续时间短、缺乏随访以及缺乏成本效益研究的限制。
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