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家长及其子女的医学无法解释的躯体症状的全科医疗咨询:系统评价。

GP consultations for medically unexplained physical symptoms in parents and their children: a systematic review.

机构信息

Arthritis Research UK Primary Care Centre, Keele University, Keele.

出版信息

Br J Gen Pract. 2013 May;63(610):e318-25. doi: 10.3399/bjgp13X667178.

Abstract

BACKGROUND

There is evidence of an association of medically unexplained physical symptoms (MUPS) between parents and children, but it is unclear whether this association is also present for GP consultations.

AIM

To review the literature investigating the association of GP consultations for MUPS between parents and children.

DESIGN OF STUDY

Systematic review.

METHOD

Systematic search of MEDLINE(®), Embase, CINAHL, and PsycINFO databases from their inception to October 2012. Observational studies examining the association of GP consultations for MUPS between parents and children were included.

RESULTS

Eight studies were included in the review. Three studies found significant associations between GP consultations for multiple MUPS between parents and children. Two studies reported significant associations between irritable bowel syndrome diagnosis in parents and multiple MUPS in children. One study showed no significant associations between multiple MUPS in mothers and functional abdominal pain in children. Two studies investigated the association of non-specific low back pain in parents and children; one study showed a significant association, whereas the other study found no significant association. Formal pooling of the results was not performed owing to a high degree of study heterogeneity.

CONCLUSION

This review provides evidence of an association between GP consultations for MUPS in parents and children, although the evidence is limited by some potential biases and study heterogeneity. GPs need to be aware of this association, which has implications for management of children presenting with MUPS. More longitudinal research focusing on all common MUPS in children, which relies on more precise sources of data, is needed to further investigate this association.

摘要

背景

有证据表明,父母和子女之间存在医学无法解释的躯体症状(MUPS)的关联,但尚不清楚这种关联是否也存在于全科医生的就诊中。

目的

综述调查父母和子女之间因 MUPS 而看全科医生的就诊的关联性的文献。

研究设计

系统评价。

方法

系统检索 MEDLINE(®)、Embase、CINAHL 和 PsycINFO 数据库,检索时间从建库至 2012 年 10 月。纳入的观察性研究评估了父母和子女之间因 MUPS 而看全科医生的就诊的关联性。

结果

综述纳入了 8 项研究。有 3 项研究发现父母因 MUPS 而多次就诊与子女间存在显著关联。有 2 项研究报告称,父母患有肠易激综合征与子女出现多种 MUPS 之间存在显著关联。有 1 项研究表明,母亲的多种 MUPS 与儿童功能性腹痛之间无显著关联。有 2 项研究调查了父母的非特异性下腰痛与子女间的关联;其中 1 项研究显示存在显著关联,而另一项研究则未发现显著关联。由于研究间存在高度异质性,未对结果进行正式汇总。

结论

本综述提供了证据表明,父母和子女之间因 MUPS 而看全科医生的就诊存在关联,但该证据受到一些潜在偏倚和研究异质性的限制。全科医生需要意识到这种关联,这对管理出现 MUPS 的儿童具有重要意义。需要开展更多针对儿童常见 MUPS 的纵向研究,该研究应更加注重精确的数据源,以进一步调查这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad6f/3635577/c0df095f73fb/bjgp-may2013-63-610-e318-OA-1.jpg

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