Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, 48106, USA. tobiass@ med.umich.edu
Nat Rev Rheumatol. 2011 Jul 19;7(9):518-27. doi: 10.1038/nrrheum.2011.98.
Individuals with fibromyalgia generally experience chronic widespread pain, which can be accompanied by further symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. As the recognition and diagnosis of fibromyalgia has improved, the availability of therapeutic options for patients has increased. Furthermore, research into the neurobiological mechanisms that contribute to the chronic pain and concomitant symptoms experienced by patients with fibromyalgia has advanced our understanding of this debilitating disorder. In this Review, we aim to provide an overview of existing pathophysiological concepts. The roles of biological and psychological stress, genetic factors, and pain and sensory processing in the pathophysiology of fibromyalgia and related conditions are discussed. In addition, pharmacological treatments, including monoamine modulators, calcium channel modulators and γ-aminobutyric acid modulators, as well as nonpharmacological treatment options are considered.
纤维肌痛患者通常会出现慢性广泛性疼痛，可能还伴有其他症状，包括疲劳、睡眠障碍、认知功能障碍、焦虑和抑郁发作。随着纤维肌痛的识别和诊断水平提高，可供患者选择的治疗方法也有所增加。此外，对导致纤维肌痛患者慢性疼痛和伴随症状的神经生物学机制的研究也加深了我们对这种使人衰弱的疾病的认识。在这篇综述中，我们旨在概述现有的病理生理学概念。讨论了生物和心理压力、遗传因素以及疼痛和感觉处理在纤维肌痛和相关疾病病理生理学中的作用。此外，还考虑了药物治疗选择，包括单胺调节剂、钙通道调节剂和γ-氨基丁酸调节剂，以及非药物治疗选择。
