Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Israel; Beer-Yaakov/Ness-Ziona, Mental Health Center, Israel.
Semin Arthritis Rheum. 2018 Aug;48(1):121-133. doi: 10.1016/j.semarthrit.2017.12.011. Epub 2018 Jan 10.
The role of physical and psychological trauma precipitating fibromyalgia is often encountered by physicians, yet a proper systematical review of this association is lacking. Literature searches identified 51 studies which examined the association of fibromyalgia with a preceding traumatic event of physical or emotional nature. The overall quality of evidence of studies included, as assessed by the GRADE criteria, was low, however the majority of studies described a significant association between prior physically traumatic events and the onset of chronic widespread pain or fibromyalgia. Elevated rates of psychological trauma in fibromyalgia patients were demonstrated across the literature and several studies indicate a mediating effect of post-traumatic stress disorder. Potential biological mechanisms for conversion of traumatic events into a chronic pain syndrome, such as fibromyalgia, are discussed.
物理和心理创伤在纤维肌痛中的诱发作用经常被医生遇到，但缺乏对这种关联的适当系统综述。文献检索确定了 51 项研究，这些研究检查了纤维肌痛与身体或情绪性质的先前创伤性事件之间的关联。纳入研究的证据总体质量，根据 GRADE 标准评估，较低，但大多数研究描述了先前身体创伤性事件与慢性广泛性疼痛或纤维肌痛发作之间的显著关联。纤维肌痛患者的心理创伤发生率较高，多项研究表明创伤后应激障碍具有中介作用。讨论了将创伤性事件转化为慢性疼痛综合征（如纤维肌痛）的潜在生物学机制。
