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[综合医学、自然疗法及补充替代医学治疗纤维肌痛综合征:基于常规治疗临床经验的概述]

[Integrative medicine, naturopathic and complementary medicine in the treatment of fibromyalgia syndrome : An overview against the background of clinical experiences from routine treatment].

作者信息

Langhorst Andrea, Langhorst Jost

机构信息

Stiftungslehrstuhl für Integrative Medizin der Universität Duisburg-Essen, Klinik für Integrative Medizin und Naturheilkunde, Sozialstiftung Bamberg, Klinikum am Bruderwald, Buger Str. 80, 96049, Bamberg, Deutschland.

出版信息

Schmerz. 2023 Oct;37(5):319-323. doi: 10.1007/s00482-023-00716-7. Epub 2023 May 22.

DOI:10.1007/s00482-023-00716-7
PMID:37217810
Abstract

Fibromyalgia syndrome is classified as a functional somatic syndrome. There are typical but not clearly defined symptom clusters, such as chronic widespread pain, non-restorative sleep, and a tendency to physical and/or mental exhaustion. The core principle of treatment in the S3 guidelines is a multimodal treatment, especially for severe forms of the disease. Complementary, naturopathic and integrative forms of treatment have an established place in the guidelines. Strong treatment recommendations with a high consensus exist for endurance, weight and functional training. Meditative forms of movement, such as yoga or qigong should also be used. In addition to a lack of physical activity, obesity is also accepted as an associated lifestyle factor and addressed in nutritional therapy and regulation therapy. The central aim is the activation and rediscovery of self-efficacy. Heat applications, such as warm baths/showers, saunas, infrared cabins or exercise in warm thermal water are in accordance with the guidelines. A current field of research is whole-body hyperthermia with water-filtered infrared A radiation. Other self-help strategies are dry brushing according to Kneipp or massaging with rosemary oil, mallow oil or the Aconite pain oil. Taking into account the patients preference, phytotherapeutic agents can also be used as herbal pain treatment (ash bark/trembling poplar bark/goldenrod herb), for sleep disorders in the form of sleep-inducing wraps (lavender heart compress) and internally (valerian, lavender oil capsules, lemon balm). Acupuncture treatment (either ear or body acupuncture) are accepted as part of a multimodal concept. The Clinic for Integrative Medicine and Naturopathy at the Hospital in Bamberg offers the three different formats of inpatient, day clinic and outpatient service covered by the health insurance.

摘要

纤维肌痛综合征被归类为功能性躯体综合征。存在典型但未明确界定的症状群,如慢性广泛性疼痛、非恢复性睡眠以及身体和/或精神疲惫倾向。S3指南中的核心治疗原则是多模式治疗,尤其是针对疾病的严重形式。辅助、自然疗法和综合治疗形式在指南中占有既定地位。对于耐力、体重和功能训练,存在高度共识的强烈治疗建议。也应采用冥想形式的运动,如瑜伽或气功。除了缺乏体育活动外,肥胖也被视为一种相关的生活方式因素,并在营养治疗和调节治疗中加以解决。核心目标是激活和重新发现自我效能感。热敷,如热水浴/淋浴、桑拿、红外线舱或在温水中锻炼,符合指南要求。当前的一个研究领域是水过滤红外A辐射全身热疗。其他自助策略包括克奈普干刷法或用迷迭香油、锦葵油或乌头止痛油按摩。考虑到患者的偏好,植物治疗剂也可作为草药止痛治疗(白蜡树皮/颤杨树皮/一枝黄花),以诱导睡眠的包裹形式(薰衣草心脏热敷)和内服(缬草、薰衣草油胶囊、柠檬香脂)治疗睡眠障碍。针刺治疗(耳针或体针)被视为多模式治疗概念的一部分。班贝格医院的综合医学与自然疗法诊所提供住院、日间门诊和门诊三种不同形式的医保服务。

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