Conaghan Philip G, Brooks Peter
Academic Unit of Musculoskeletal Disease, 2nd floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK.
Best Pract Res Clin Rheumatol. 2008 Jun;22(3):387-94. doi: 10.1016/j.berh.2008.02.004.
Musculoskeletal conditions are becoming more prevalent in the aging and increasingly overweight Western population. Many such conditions are chronic, and most people concerned have problems with more than one anatomical joint region, resulting in cumulatively increased problems with performing daily tasks. Management is complex because of the chronic nature of many of these conditions, the need for regular assessment of disease impact, the individual's responses to the disease and its treatment, the presence of co-morbidities, and the lack of well-designed studies of long-term outcome to guide treatment. There are significant issues about how to monitor outcomes in routine practice, and many outcome measures have been developed for use in clinical trials. Principles of modern management include involvement of people in their own care, early intervention, and the need to consider a multidisciplinary approach. Most conditions will require combinations of one or more non-pharmacological therapies (especially muscle strengthening and aerobic exercise) and pharmacological agents, with attention given to appropriate timing of surgical interventions.
肌肉骨骼疾病在老龄化且超重情况日益严重的西方人群中愈发普遍。许多此类疾病是慢性的，而且大多数患者不止一个解剖关节区域存在问题，导致日常活动累积出现更多问题。由于其中许多疾病具有慢性性质、需要定期评估疾病影响、个体对疾病及其治疗的反应、合并症的存在以及缺乏精心设计的长期疗效研究来指导治疗，管理工作十分复杂。在常规实践中如何监测疗效存在重大问题，并且已经开发了许多疗效指标用于临床试验。现代管理原则包括让患者参与自身护理、早期干预以及需要考虑多学科方法。大多数疾病需要一种或多种非药物疗法（尤其是肌肉强化和有氧运动）与药物制剂相结合，并注意手术干预的适当时机。
