Wierwille Lauren
University of Maryland, Baltimore, MD, USA.
J Am Acad Nurse Pract. 2012 Apr;24(4):184-92. doi: 10.1111/j.1745-7599.2011.00671.x. Epub 2011 Nov 11.
The purpose of this clinical review is to clarify and discuss the diagnosis and management of fibromyalgia. This includes typical signs and symptoms, pathophysiology, concomitant disease states, differential diagnoses, and recommended pharmacologic and nonpharmacologic treatment modalities.
The search included Evidence Based Medicine Reviews, Ovid MEDLINE, PubMed, and CINAHL. Search terms used: fibromyalgia diagnosis, fibromyalgia pathophysiology, incidence of fibromyalgia, fibromyalgia comorbidities, etiology of fibromyalgia, fibromyalgia treatment, American College of Rheumatology criteria. Search limited to sources from 1990 to 2010.
Fibromyalgia is a complex muscular rheumatism that is not fully understood and often misdiagnosed. Signs and symptoms may overlap with many other conditions that must be properly ruled out to prevent diagnosis based upon arbitrary clinical judgment. Treatment is most beneficial when tailored to individual patient presentation, and further research is warranted, particularly in the domains of pathophysiology and efficacy of treatment options.
An accurate knowledge of current research will aid the nurse practitioner in effectively prescribing evidence-based clinical interventions. Optimal fibromyalgia management can be achieved through a multifaceted treatment approach and is enhanced with early identification of the disease process.
本临床综述的目的是阐明并讨论纤维肌痛的诊断与管理。这包括典型的体征和症状、病理生理学、伴发疾病状态、鉴别诊断以及推荐的药物和非药物治疗方式。
检索包括循证医学综述、Ovid MEDLINE、PubMed和CINAHL。使用的检索词：纤维肌痛诊断、纤维肌痛病理生理学、纤维肌痛发病率、纤维肌痛合并症、纤维肌痛病因、纤维肌痛治疗、美国风湿病学会标准。检索限于1990年至2010年的资料来源。
纤维肌痛是一种复杂的肌肉风湿病，尚未被完全理解，且常被误诊。其体征和症状可能与许多其他病症重叠，必须予以恰当排除，以防基于随意的临床判断进行诊断。根据个体患者的表现进行治疗最为有益，并且有必要开展进一步研究，尤其是在病理生理学和治疗方案疗效方面。
准确了解当前研究将有助于执业护士有效地开具循证临床干预措施。通过多方面的治疗方法可实现纤维肌痛的最佳管理，且早期识别疾病过程可增强管理效果。
