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[儿童和青少年慢性广泛性疼痛及所谓纤维肌痛综合征的定义、诊断与治疗。系统文献综述与指南]

[Definition, diagnosis and therapy of chronic widespread pain and so-called fibromyalgia syndrome in children and adolescents. Systematic literature review and guideline].

作者信息

Zernikow B, Gerhold K, Bürk G, Häuser W, Hinze C H, Hospach T, Illhardt A, Mönkemöller K, Richter M, Schnöbel-Müller E, Häfner R

机构信息

Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.

出版信息

Schmerz. 2012 Jun;26(3):318-30. doi: 10.1007/s00482-012-1168-y.

Abstract

BACKGROUND

The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011.

MATERIALS AND METHODS

The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy ("Deutsche Interdisziplinären Vereinigung für Schmerztherapie", DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields. Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine. The formulation and grading of recommendations was accomplished using a multi-step, formal consensus process. The guidelines were reviewed by the boards of the participating scientific medical societies.

RESULTS AND CONCLUSION

The diagnosis FMS in children and adolescents is not established. In so-called juvenile FMS (JFMS) multidimensional diagnostics with validated measures should be performed. Multimodal therapy is warranted. In the case of severe pain-related disability, therapy should be primarily performed on an inpatient basis. The English full-text version of this article is available at SpringerLink (under "Supplemental").

摘要

背景

德国科学医学协会联合会(“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”,AWMF;注册号041/004)计划于2011年3月开始对德国纤维肌痛综合征(FMS)的S3指南进行定期更新。

材料与方法

该指南的制定由德国疼痛治疗跨学科协会(“Deutsche Interdisziplinären Vereinigung für Schmerztherapie”,DIVS)、9个科学医学协会和2个患者自助组织协调。八个工作组共有50名成员,在性别、医学领域、潜在利益冲突以及医学和科学领域的层级地位方面实现了均衡。使用Medline、PsycInfo、Scopus和Cochrane图书馆数据库进行文献检索(截至2010年12月)。证据强度分级遵循牛津循证医学中心的方案。建议的制定和分级通过多步骤的正式共识过程完成。这些指南由参与的科学医学协会的董事会进行了审查。

结果与结论

儿童和青少年的FMS诊断尚未确立。在所谓的青少年FMS(JFMS)中,应采用经过验证的措施进行多维度诊断。多模式治疗是必要的。对于与疼痛相关的严重残疾,治疗应主要在住院基础上进行。本文的英文全文版本可在SpringerLink上获取(在“补充材料”下)。

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