Gur Ali, Oktayoglu Pelin
Department of Physical Medicine and Rehabilitation, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
Department of Physical Medicine and Rehabilitation, Batman State Hospital, Batman, Turkey.
Open Access Rheumatol. 2009 Dec 9;1:193-209. doi: 10.2147/oarrr.s8040. eCollection 2009.
Fibromyalgia (FM) is characterized as a chronic, painful, noninflammatory syndrome affecting the musculoskeletal system. In addition to pain, common co-morbid symptoms associated with FM include sleep disturbances, fatigue, morning stiffness, affective disorders, chronic daily headache, dyscognition, irritable bowel syndrome, and irritable bladder. Fibromyalgia is usually classified by application of the American College of Rheumatology (ACR) criteria. Although these criteria are accepted among investigators who agree with the concept of fibromyalgia, they do so with some reservations. Tender points and widespread pain alone does not describe the esence of fibromyalgia. New diagnostic tools including either clinical or radiological components are studied to diminish these problems. Although various pharmacological solutions have been studied for treating fibromyalgia, no single drug or groups of drugs have proved to be useful in treating fibromyalgia patients. Recently, three drugs, pregabalin, duloxetine and milnacipran, were approved for the treatment of FM by the US Food and Drug Administration (FDA). Novel therapeutic approaches to the management of FM include cannabinoids, sodium channel blockade and new generation antiepileptics. This review evaluates both new diagnostic tools, including clinical or radiological regimes, and tries to highlight the efficacy of medicinal and nonmedicinal treatments with new therapeutic approaches in the management of FM with a wide perspective.
纤维肌痛（FM）是一种影响肌肉骨骼系统的慢性、疼痛性、非炎症性综合征。除疼痛外，与纤维肌痛相关的常见共病症状包括睡眠障碍、疲劳、晨僵、情感障碍、慢性每日头痛、认知障碍、肠易激综合征和膀胱易激惹。纤维肌痛通常根据美国风湿病学会（ACR）标准进行分类。尽管这些标准在认同纤维肌痛概念的研究者中被接受，但他们也有所保留。仅压痛点和广泛疼痛并不能描述纤维肌痛的本质。正在研究包括临床或放射学成分在内的新诊断工具以减少这些问题。尽管已经研究了各种药物治疗方法来治疗纤维肌痛，但没有一种单一药物或药物组被证明对治疗纤维肌痛患者有效。最近，普瑞巴林、度洛西汀和米那普明三种药物被美国食品药品监督管理局（FDA）批准用于治疗纤维肌痛。纤维肌痛管理的新治疗方法包括大麻素、钠通道阻滞和新一代抗癫痫药。本综述评估了包括临床或放射学方案在内的新诊断工具，并试图从广泛的角度突出新治疗方法在纤维肌痛管理中的药物和非药物治疗效果。
