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纤维肌痛综合征——一种多学科方法。

Fibromyalgia Syndrome - a multidisciplinary approach.

作者信息

Binkiewicz-Glińska Anna, Bakuła Stanisław, Tomczak Hanna, Landowski Jerzy, Ruckemann-Dziurdzińska Katarzyna, Zaborowska-Sapeta Katarzyna, Kowalski Ireneusz, Kiebzak Wojciech

机构信息

Katedra Rehabilitacji GUMed w Gdańsku.

Klinika Rehabilitacji Uniwersyteckiego Centrum Klinicznego w Gdańsku.

出版信息

Psychiatr Pol. 2015;49(4):801-10. doi: 10.12740/psychiatriapolska.pl/online-first/4.

Abstract

According to American College of Rheumatology fibromyalgia syndrome (FMS) is a common health problem characterized by widespread pain and tenderness. The pain and tenderness, although chronic, present a tendency to fluctuate both in intensity and location around the body. Patients with FMS experience fatigue and often have sleep disorders. It is estimated that FMS affects two to four percent of the general population. It is most common in women, though it can also occur in men. FMS most often first occur in the middle adulthood, but it can start as early as in the teen years or in the old age. The causes of FMS are unclear. Various infectious agents have recently been linked with the development of FMS. Some genes are potentially linked with an increased risk of developing FMS and some other health problems, which are common comorbidities to FMS. It is the genes that determine individual sensitivity and reaction to pain, quality of the antinociceptive system and complex biochemistry of pain sensation. Diagnosis and therapy may be complex and require cooperation of many specialists. Rheumatologists often make the diagnosis and differentiate FMS with other disorders from the rheumatoid group. FMS patients may also require help from the Psychiatric Clinic (Out-Patients Clinic) due to accompanying mental problems. As the pharmacological treatment options are limited and only complex therapy gives relatively good results, the treatment plan should include elements of physical therapy.

摘要

根据美国风湿病学会的定义,纤维肌痛综合征(FMS)是一种常见的健康问题,其特征为全身广泛疼痛和压痛。疼痛和压痛虽为慢性,但在强度和身体部位上呈现出波动的趋势。FMS患者会感到疲劳,且常伴有睡眠障碍。据估计,FMS影响着2%至4%的普通人群。它在女性中最为常见,不过男性也可能发病。FMS最常首次出现在中年时期,但也可能早在青少年时期或老年期就开始发病。FMS的病因尚不清楚。最近发现多种感染因子与FMS的发病有关。一些基因可能与患FMS的风险增加以及其他一些健康问题有关,这些问题是FMS常见的共病。正是基因决定了个体对疼痛的敏感性和反应、抗伤害感受系统的质量以及疼痛感觉的复杂生物化学过程。诊断和治疗可能较为复杂,需要许多专科医生的合作。风湿病学家常做出诊断,并将FMS与类风湿性疾病组中的其他疾病区分开来。由于伴有精神问题,FMS患者可能还需要精神科门诊的帮助。由于药物治疗选择有限,只有综合治疗才能取得相对较好的效果,因此治疗方案应包括物理治疗的内容。

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