van Ravenzwaaij J, Olde Hartman Tc, van Ravesteijn H, Eveleigh R, van Rijswijk E, Lucassen Plbj
Family Physician.
Ment Health Fam Med. 2010 Dec;7(4):223-31.
Background Medically unexplained symptoms (MUS) are common in primary health care. Both patients and doctors are burdened with the symptoms that negatively affect patients' quality of life. General practitioners (GPs) often face difficulties when giving patients legitimate and convincing explanations for their symptoms. This explanation is important for reassuring patients and for maintaining a good doctor-patient communication and relationship.Objective To provide an overview of explanatory models for MUS.Study design We performed a systematic search of reviews in PsycINFO and PubMed about explanatory models of MUS. We performed a qualitative analysis of the data according to the principles of constant comparative analysis to identify specific explanatory models.Results We distinguished nine specific explanatory models of MUS in the literature: somatosensory amplification, sensitisation, sensitivity, immune system sensitisation, endocrine dysregulation, signal filter model, illness behaviour model, autonomous nervous system dysfunction and abnormal proprioception. The nine different explanatory models focus on different domains, including somatic causes, perception, illness behaviour and predisposition. We also found one meta-model, which incorporates these four domains: the cognitive behavioural therapy model.Conclusion Although GPs often face difficulties when providing explanations to patients with MUS, there are multiple explanatory models in the scientific literature that may be of use in daily medical practice.
医学上无法解释的症状（MUS）在初级卫生保健中很常见。患者和医生都受到这些症状的困扰，这些症状会对患者的生活质量产生负面影响。全科医生（GPs）在为患者的症状提供合理且有说服力的解释时常常面临困难。这种解释对于安抚患者以及维持良好的医患沟通和关系很重要。
概述医学上无法解释的症状的解释模型。
我们在PsycINFO和PubMed中对关于医学上无法解释的症状的解释模型的综述进行了系统检索。我们根据持续比较分析的原则对数据进行了定性分析，以确定具体的解释模型。
我们在文献中区分出医学上无法解释的症状的九种具体解释模型：体感放大、致敏作用、敏感性、免疫系统致敏、内分泌失调、信号过滤模型、疾病行为模型、自主神经系统功能障碍和异常本体感觉。这九种不同的解释模型关注不同的领域，包括躯体原因、感知、疾病行为和易感性。我们还发现了一个元模型，它整合了这四个领域：认知行为疗法模型。
尽管全科医生在为患有医学上无法解释的症状的患者提供解释时常常面临困难，但科学文献中有多种解释模型可能在日常医疗实践中有用。
