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Fibromyalgia Syndrome: A Metabolic Approach Grounded in Biochemistry for the Remission of Symptoms.纤维肌痛综合征:一种基于生物化学实现症状缓解的代谢疗法。
Front Med (Lausanne). 2017 Nov 13;4:198. doi: 10.3389/fmed.2017.00198. eCollection 2017.
2
Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology.纤维肌痛综合征治疗指南更新:聚焦药理学
Biomedicines. 2017 May 8;5(2):20. doi: 10.3390/biomedicines5020020.
3
The placebo effect and its determinants in fibromyalgia: meta-analysis of randomised controlled trials.纤维肌痛中的安慰剂效应及其决定因素:随机对照试验的荟萃分析
Clin Rheumatol. 2017 Jul;36(7):1623-1630. doi: 10.1007/s10067-017-3595-8. Epub 2017 Mar 15.
4
2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria.2016年对2010/2011年纤维肌痛诊断标准的修订。
Semin Arthritis Rheum. 2016 Dec;46(3):319-329. doi: 10.1016/j.semarthrit.2016.08.012. Epub 2016 Aug 30.
5
Fibromyalgia: clinical features, diagnosis and management.纤维肌痛:临床特征、诊断与管理
Nurs Stand. 2016 Sep 28;31(5):51-63. doi: 10.7748/ns.2016.e10550.
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EULAR revised recommendations for the management of fibromyalgia.EULAR 修订的纤维肌痛管理建议。
Ann Rheum Dis. 2017 Feb;76(2):318-328. doi: 10.1136/annrheumdis-2016-209724. Epub 2016 Jul 4.
7
Fibromyalgia-related costs and loss of productivity: a substantial societal burden.纤维肌痛相关的成本和生产力损失:一项沉重的社会负担。
BMC Musculoskelet Disord. 2016 Apr 16;17:168. doi: 10.1186/s12891-016-1027-6.
8
Selective serotonin reuptake inhibitors for fibromyalgia syndrome.用于纤维肌痛综合征的选择性5-羟色胺再摄取抑制剂
Cochrane Database Syst Rev. 2015 Jun 5;2015(6):CD011735. doi: 10.1002/14651858.CD011735.
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Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia.度洛西汀用于治疗疼痛性神经病变、慢性疼痛或纤维肌痛。
Cochrane Database Syst Rev. 2014 Jan 3;2014(1):CD007115. doi: 10.1002/14651858.CD007115.pub3.
10
Dietary fructose intolerance, fructan intolerance and FODMAPs.膳食果糖不耐受、果聚糖不耐受与可发酵的寡糖、双糖、单糖和多元醇
Curr Gastroenterol Rep. 2014 Jan;16(1):370. doi: 10.1007/s11894-013-0370-0.

纤维肌痛综合征:通过饮食策略实现症状可控缓解的病例报告。

Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy.

作者信息

Lattanzio Silvia Maria, Imbesi Francesca

机构信息

Department of Biomedical Sciences, University of Padova, Padova, Italy.

Neurological Department, Ospedale Niguarda Ca' Granda, Milan, Italy.

出版信息

Front Med (Lausanne). 2018 Apr 30;5:94. doi: 10.3389/fmed.2018.00094. eCollection 2018.

DOI:10.3389/fmed.2018.00094
PMID:29761101
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5936760/
Abstract

A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.

摘要

一名34岁女性患有严重的慢性疼痛、抑郁、睡眠不佳、慢性疲劳、严重晨僵、腿部痉挛、肠易激综合征、对寒冷敏感、注意力不集中和健忘。血液检查风湿性疾病呈阴性。该患者被诊断为纤维肌痛综合征(FMS)。由于药物治疗对FMS无效,她采用了一种新的代谢方案以实现症状缓解。其核心思想是通过使食物中摄入的色氨酸得到适当吸收来支持血清素合成,同时避免或至少尽量减少干扰性未吸收分子(如果糖和山梨醇)的存在。这样的策略在饮食几天后症状迅速改善,2个月内大多数症状得以缓解。抑郁、广泛的慢性疼痛、慢性疲劳、睡眠不佳、晨僵以及大多数合并症都得到了缓解。患者恢复了发病前的精力和活力,扭转了职业和社会残疾状况。患者偶尔违反饮食方案,结果导致症状复发,这支持了饮食设计背后生化假说对症状缓解的正确性,但并非最终治愈方法。我们建议将此作为一种低风险且易于实施的治疗方案,用于FMS的症状缓解,除了在缺乏维生素和矿物质盐时补充相关物质外,几乎没有其他成本。需要进行一项试点研究来进一步夯实这种代谢方法,并最终评估其是否纳入FMS临床管理指南。