David A S, Wessely S, Pelosi A J
Maudsley Hospital, London.
Br Med J (Clin Res Ed). 1988 Mar 5;296(6623):696-9. doi: 10.1136/bmj.296.6623.696.
Controversial views on the postviral fatigue syndrome ("myalgic encephalomyelitis") were critically appraised in their historical context and recent advances in research (virology, immunology, neurophysiology, histopathology, and epidemiology) reviewed. Flaws detected in certain aspects of recent research included in particular failure to define fatigue, inadequate assessment of psychological features, and absent or inappropriate control groups. The findings suggest that the fruitless dichotomy of "organic versus functional" should be replaced by a multifactorial approach. Most important, epidemiological studies with explicit operational case definition are essential before progress can be made in the management of this distressing disorder.
对病毒性疲劳综合征(“肌痛性脑脊髓炎”)的争议性观点在其历史背景下得到了批判性评估,并回顾了研究(病毒学、免疫学、神经生理学、组织病理学和流行病学)的最新进展。近期研究某些方面发现的缺陷尤其包括未能定义疲劳、对心理特征评估不足以及缺乏或不适当的对照组。研究结果表明,“器质性与功能性”这种无果的二分法应被多因素方法所取代。最重要的是,在有效治疗这种令人苦恼疾病之前,进行具有明确操作性病例定义的流行病学研究至关重要。