Charité-University Medical Center, Institute of Social Medicine, Epidemiology and Health Economics, 10098 Berlin, Germany ; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany.
Evid Based Complement Alternat Med. 2013;2013:908610. doi: 10.1155/2013/908610. Epub 2013 Jan 23.
Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM). We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM) approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ) score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P < 0.014) and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.
纤维肌痛症的治疗颇具挑战。最近的指南建议纤维肌痛症应采用多学科治疗方法进行治疗。目前尚无评估整合医学（IM）多模式治疗策略的数据。我们进行了一项对照、非随机的试点研究，比较了两种住院治疗策略，一种是包括禁食疗法的 IM 方法，另一种是常规风湿病学（CM）方法。IM 使用禁食疗法和身心医学作为特定方法。在纳入的 48 例连续患者中，28 例接受 IM 治疗，20 例接受 CM 治疗。主要结局是 2 周住院后纤维肌痛影响问卷（FIQ）评分的变化。次要结局包括疼痛、抑郁、焦虑和健康状况评分。评估在 12 周后重复进行。2 周时，与 CM 组相比，IM 组的 FIQ（P<0.014）和大多数次要结局的评分均有显著改善。IM 方法的有益效果在 12 周后降低，除焦虑外，不再具有统计学意义。结果表明，在短期内，多模式 IM 治疗联合禁食疗法可能优于 CM，中期则无差异。需要进行更长期的研究来评估整合多模式治疗在纤维肌痛中的临床影响。
