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我们应该做出纤维肌痛的诊断吗?

[Should we make the diagnosis of fibromyalgia?].

作者信息

Cathébras Pascal, Lauwers Anne

机构信息

Service de médecine interne, hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne Cedex 2, France.

出版信息

Rev Prat. 2009 Jan 20;59(1):25-31.

Abstract

Fibromyalgia is a functional somatic syndrome characterized by widespread musculoskeletal pain, fatigue, poor sleep, and exercise intolerance, frequently (but inconstantly) associated with psychological distress. Fibromyalgia is a common condition, affecting predominantly middle-aged women, with a chronic course. Fibromaylgia should be differentiated from, and may be associated with, a number of metabolic, rheumatic, neurological or psychiatric conditions. The most plausible pathophysiologic mechanism involves an alteration of pain modulation at the peripheral and central levels of the nervous system ("sensitization"). Psychosocial factors play an important role in precipitating and maintaining symptoms, health care utilization, and disablement. Treatments of fibromyalgia rely mainly on the acknowledgement of pain and distress, patient education, analgesics, balneotherapy and physiotherapy, physical reconditioning (aerobic exercise), and certain antidepressants.

摘要

纤维肌痛是一种功能性躯体综合征,其特征为广泛的肌肉骨骼疼痛、疲劳、睡眠不佳和运动不耐受,常(但并非始终)伴有心理困扰。纤维肌痛是一种常见病症,主要影响中年女性,病程呈慢性。纤维肌痛应与多种代谢、风湿、神经或精神疾病相鉴别,且可能与之相关。最合理的病理生理机制涉及神经系统外周和中枢水平疼痛调节的改变(“致敏作用”)。社会心理因素在症状的引发和维持、医疗保健利用及残疾方面起着重要作用。纤维肌痛的治疗主要依赖于对疼痛和困扰的认知、患者教育、镇痛药、温泉疗法和物理疗法、身体调理(有氧运动)以及某些抗抑郁药。

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