慢性疼痛和疲劳的挑战。
The challenges of chronic pain and fatigue.
机构信息
Brighton and Sussex Medical School, Falmer, UK, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK and Sussex Partnership Foundation NHS Trust, Brighton, UK
Brighton and Sussex Medical School, Falmer, UK and medical director, The Advisory Committee on Clinical Excellence Awards (ACCEA), Leeds, UK.
出版信息
Clin Med (Lond). 2021 Jan;21(1):19-27. doi: 10.7861/clinmed.2020-1009.
Abstract
In this review, we explore the challenges of chronic pain and fatigue in clinical practice. Both pain and fatigue are common, troubling and frequently overlapping symptoms, and we describe both the clinical burden and the 'clinical problem'. We explore commonly associated symptoms and possible pathological associations, including variant connective tissue (joint hypermobility), small fibre neuropathy, mast cell activation, dysregulated inflammatory and interoceptive processes, which may inform treatment targets. We suggest a multidisciplinary management approach.
摘要
在这篇综述中，我们探讨了临床实践中慢性疼痛和疲劳的挑战。疼痛和疲劳都是常见的、令人困扰的、且经常重叠的症状，我们描述了这两种症状的临床负担和“临床问题”。我们探讨了常见的相关症状和可能的病理关联，包括变异的结缔组织（关节过度活动）、小纤维神经病、肥大细胞激活、失调的炎症和内脏感知过程，这些可能为治疗靶点提供信息。我们建议采用多学科管理方法。
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Trials. 2021 Sep 21;22(1):645. doi: 10.1186/s13063-021-05555-4.
2
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3
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5
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