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本文引用的文献

1
Altering Dynamics of Autonomic Processing Therapy (ADAPT) trial: a novel, targeted treatment for reducing anxiety in joint hypermobility.自主神经处理治疗（ADAPT）试验的改变：一种减少关节过度活动症焦虑的新型靶向治疗方法。
Trials. 2021 Sep 21;22(1):645. doi: 10.1186/s13063-021-05555-4.
2
Beyond bones: The relevance of variants of connective tissue (hypermobility) to fibromyalgia, ME/CFS and controversies surrounding diagnostic classification: an observational study.超越骨骼：结缔组织（高活动性）变体与纤维肌痛、ME/CFS 以及围绕诊断分类的争议的相关性：一项观察性研究。
Clin Med (Lond). 2021 Jan;21(1):53-58. doi: 10.7861/clinmed.2020-0743.
3
Headaches in hypermobility syndromes: A pain in the neck?易发性运动障碍综合征相关头痛：脖子疼？
Am J Med Genet A. 2020 Dec;182(12):2902-2908. doi: 10.1002/ajmg.a.61873. Epub 2020 Sep 17.
4
Functional gastrointestinal disorders are increased in joint hypermobility-related disorders with concomitant postural orthostatic tachycardia syndrome.功能性胃肠疾病在与体位性心动过速综合征相关的关节过度活动相关疾病中增加。
Neurogastroenterol Motil. 2020 Dec;32(12):e13975. doi: 10.1111/nmo.13975. Epub 2020 Aug 16.
5
The Ehlers-Danlos syndromes.埃勒斯-当洛斯综合征。
Nat Rev Dis Primers. 2020 Jul 30;6(1):64. doi: 10.1038/s41572-020-0194-9.
6
Serum proteome profiles revealed dysregulated proteins and mechanisms associated with fibromyalgia syndrome in women.血清蛋白质组谱揭示了与女性纤维肌痛综合征相关的失调蛋白和机制。
Sci Rep. 2020 Jul 23;10(1):12347. doi: 10.1038/s41598-020-69271-w.
7
Persistent Symptoms in Patients After Acute COVID-19.急性 COVID-19 后患者的持续症状。
JAMA. 2020 Aug 11;324(6):603-605. doi: 10.1001/jama.2020.12603.
8
A new insight on postural tachycardia syndrome in 102 adults with hypermobile Ehlers-Danlos Syndrome/hypermobility spectrum disorder.102 例弹性纤维性假黄瘤/过度活动综合征患者的直立性心动过速综合征新见解。
Monaldi Arch Chest Dis. 2020 May 20;90(2). doi: 10.4081/monaldi.2020.1286.
9
Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD.肠易激、慢性广泛性疼痛、慢性疲劳及相关综合征在普通人群中普遍存在且高度重叠：DanFunD。
Sci Rep. 2020 Feb 24;10(1):3273. doi: 10.1038/s41598-020-60318-6.
10
Impact of Endometriosis Diagnostic Delays on Healthcare Resource Utilization and Costs.子宫内膜异位症诊断延迟对医疗资源利用和成本的影响。
Adv Ther. 2020 Mar;37(3):1087-1099. doi: 10.1007/s12325-019-01215-x. Epub 2020 Jan 20.

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.

DOI:10.7861/clinmed.2020-1009
PMID:33479064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7850224/
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。