Biomedical Research Centre, Sheffield Hallam University, Faculty of Health and Wellbeing, City Campus, Sheffield S1 1WB, UK.
Neuropsychiatr Dis Treat. 2008 Dec;4(6):1059-71. doi: 10.2147/ndt.s3468.
Fibromyalgia (FM) is a common, complex, and difficult to treat chronic widespread pain disorder, which usually requires a multidisciplinary approach using both pharmacological and non-pharmacological (education and exercise) interventions. It is a condition of heightened generalized sensitization to sensory input presenting as a complex of symptoms including pain, sleep dysfunction, and fatigue, where the pathophysiology could include dysfunction of the central nervous system pain modulatory systems, dysfunction of the neuroendocrine system, and dysautonomia. A cyclic model of the pathophysiological processes is compatible with the interrelationship of primary symptoms and the array of postulated triggers associated with FM. Many of the molecular targets of current and emerging drugs used to treat FM have been focused to the management of discrete symptoms rather than the condition. Recently, drugs (eg, pregabalin, duloxetine, milnacipran, sodium oxybate) have been identified that demonstrate a multidimensional efficacy in this condition. Although the complexity of FM suggests that monotherapy, non-pharmacological or pharmacological, will not adequately address the condition, the outcomes from recent clinical trials are providing important clues for treatment guidelines, improved diagnosis, and condition-focused therapies.
纤维肌痛（FM）是一种常见的、复杂的、难以治疗的慢性广泛性疼痛障碍，通常需要采用多学科方法，同时使用药物和非药物干预措施（教育和锻炼）。这是一种对感觉输入高度敏感的全身性疾病，表现为一系列症状，包括疼痛、睡眠功能障碍和疲劳，其病理生理学可能包括中枢神经系统疼痛调节系统功能障碍、神经内分泌系统功能障碍和自主神经功能障碍。病理生理过程的周期性模型与主要症状的相互关系以及与 FM 相关的一系列假定触发因素相兼容。目前和新兴用于治疗 FM 的药物的许多分子靶点都集中在管理离散症状上，而不是针对该疾病。最近，已经确定了一些药物（例如普瑞巴林、度洛西汀、米那普仑、羟丁酸钠），它们在这种情况下具有多维疗效。尽管 FM 的复杂性表明单药治疗、非药物或药物治疗都不能充分解决该疾病，但最近临床试验的结果为治疗指南、改善诊断和针对疾病的治疗提供了重要线索。
