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慢性疲劳综合征:人们可以从中恢复的真实疾病。

Chronic fatigue syndromes: real illnesses that people can recover from.

机构信息

Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.

Department of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Scand J Prim Health Care. 2023 Dec;41(4):372-376. doi: 10.1080/02813432.2023.2235609. Epub 2023 Nov 29.

Abstract

The 'Oslo Chronic Fatigue Consortium' consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.

摘要

“奥斯陆慢性疲劳综合征联合会”由研究人员和临床医生组成,他们对当前慢性疲劳综合征(包括新冠后疾病)无法治愈的说法提出质疑。相反,我们基于研究提出了另一种观点,为患者带来了更多的希望。虽然我们认为这些病症的症状是真实存在的,但我们认为,它们更可能反映出大脑对一系列生物、心理和社会因素的反应,而不是特定的疾病过程。可能的原因包括神经生物学应激反应的持续激活,伴随着免疫、荷尔蒙、认知和行为领域的相关变化。我们进一步提出,如果这些症状被认为是威胁性的,并且避免所有被认为会加重症状的活动,那么这些症状更有可能持续存在。我们还对这样一种观点提出质疑,即应对疾病的最佳方法是长时间休息、社会隔离和感官剥夺。相反,如果患者能够理解他们的症状,并且得到支持,逐渐恢复正常活动,那么他们通常可以康复。最后,我们呼吁就这些病症进行更开放和建设性的对话。这种对话应该包括更广泛的观点,包括那些已经从这些病症中康复的患者的观点。

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