Division of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada.
Pain Res Manag. 2013 May-Jun;18(3):119-26. doi: 10.1155/2013/918216.
Recent neurophysiological evidence attests to the validity of fibromyalgia (FM), a chronic pain condition that affects >2% of the population.
To present the evidence-based guidelines for the diagnosis, management and patient trajectory of individuals with FM.
A needs assessment following consultation with diverse health care professionals identified questions pertinent to various aspects of FM. A literature search identified the evidence available to address these questions; evidence was graded according to the standards of the Oxford Centre for Evidence-Based Medicine. Drafted recommendations were appraised by an advisory panel to reflect meaningful clinical practice.
The present recommendations incorporate the new clinical concepts of FM as a clinical construct without any defining physical abnormality or biological marker, characterized by fluctuating, diffuse body pain and the frequent symptoms of sleep disturbance, fatigue, mood and cognitive changes. In the absence of a defining cause or cure, treatment objectives should be patient-tailored and symptom-based, aimed at reducing global complaints and enhancing function. Healthy lifestyle practices with active patient participation in health care forms the cornerstone of care. Multimodal management may include nonpharmacological and pharmacological strategies, although it must be acknowledged that pharmacological treatments provide only modest benefit. Maintenance of function and retention in the workforce is encouraged.
The new Canadian guidelines for the treatment of FM should provide health professionals with confidence in the complete care of these patients and improve clinical outcomes.
最近的神经生理学证据证明了纤维肌痛（FM）的有效性，这是一种影响超过 2%人口的慢性疼痛疾病。
提出纤维肌痛患者的诊断、管理和患者轨迹的循证指南。
在与不同医疗保健专业人员协商后进行需求评估，确定与 FM 的各个方面相关的问题。文献检索确定了可用于解决这些问题的证据；证据根据牛津循证医学中心的标准进行分级。起草的建议由顾问小组进行评估，以反映有意义的临床实践。
本建议纳入了纤维肌痛作为一种临床结构的新概念，没有任何确定的身体异常或生物学标志物，其特征是波动、弥漫性身体疼痛以及睡眠障碍、疲劳、情绪和认知变化等常见症状。由于没有确定的病因或治愈方法，治疗目标应根据患者的具体情况和症状制定，旨在减轻全身症状和提高功能。以积极参与医疗保健的健康生活方式实践为护理的基石。多模式管理可能包括非药物和药物策略，尽管必须承认药物治疗只能提供适度的益处。鼓励保持功能和保留在工作场所。
新的加拿大纤维肌痛治疗指南应使医疗保健专业人员对这些患者的全面护理充满信心，并改善临床结果。
