纤维肌痛管理的神经营养方法:一项叙述性综述。
Neuronutritional Approach to Fibromyalgia Management: A Narrative Review.
作者信息
Badaeva Anastasiia, Danilov Alexey, Kosareva Anastasiia, Lepshina Mariia, Novikov Viacheslav, Vorobyeva Yulia, Danilov Andrey
机构信息
Department for Pathological Physiology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia.
Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia.
出版信息
Pain Ther. 2024 Oct;13(5):1047-1061. doi: 10.1007/s40122-024-00641-2. Epub 2024 Jul 23.
Fibromyalgia (FM) is a complex and common syndrome characterized by chronic widespread pain, fatigue, sleep disturbances, and various functional symptoms without clear structural or pathological causes. Affecting approximately 1-5% of the global population, with a higher prevalence in women, FM significantly impacts patients' quality of life, often leading to considerable healthcare costs and loss of productivity. Despite its prevalence, the etiology of FM remains elusive, with genetic, environmental, and psychological factors, including nutrition, being implicated. Currently, no universally accepted treatment guidelines exist, and management strategies are often symptomatic. This narrative review explores the potential of a neuronutritional approach to FM management. It synthesizes existing research on the relationship between FM and nutrition, suggesting that dietary interventions could be a promising complementary treatment strategy. Various nutritional interventions, including vitamin D, magnesium, iron, and probiotics supplementation, have shown potential in reducing FM symptoms, such as chronic pain, anxiety, depression, cognitive dysfunction, sleep disturbances, and gastrointestinal issues. Additionally, weight loss has been associated with reduced inflammation and improved quality of life in FM patients. The review highlights the anti-inflammatory benefits of plant-based diets and the low-FODMAPs diet, which have shown promise in managing FM symptoms and related gastrointestinal disorders. Supplements such as vitamin D, magnesium, vitamin B12, coenzyme Q10, probiotics, omega-3 fatty acids, melatonin, S-adenosylmethionine, and acetyl-L-carnitine are discussed for their potential benefits in FM management through various mechanisms, including anti-inflammatory effects, modulation of neurotransmitters, and improvement of mitochondrial function. In conclusion, this review underscores the importance of considering neuronutrition as a holistic approach to FM treatment, advocating for further research and clinical trials to establish comprehensive dietary guidelines and to optimize management strategies for FM patients.
纤维肌痛(FM)是一种复杂且常见的综合征,其特征为慢性广泛性疼痛、疲劳、睡眠障碍以及各种功能性症状,却无明确的结构或病理原因。FM影响着全球约1%-5%的人口,女性患病率更高,它对患者的生活质量有显著影响,常常导致可观的医疗费用和生产力损失。尽管其患病率较高,但FM的病因仍不明确,涉及遗传、环境和心理因素,包括营养因素。目前,尚无普遍接受的治疗指南,管理策略通常是对症治疗。这篇叙述性综述探讨了神经营养方法在FM管理中的潜力。它综合了关于FM与营养之间关系的现有研究,表明饮食干预可能是一种有前景的辅助治疗策略。各种营养干预措施,包括补充维生素D、镁、铁和益生菌,已显示出在减轻FM症状方面的潜力,如慢性疼痛、焦虑、抑郁、认知功能障碍、睡眠障碍和胃肠道问题。此外,体重减轻与FM患者炎症减轻和生活质量改善有关。该综述强调了植物性饮食和低发酵性寡糖、双糖、单糖和多元醇(FODMAPs)饮食的抗炎益处,它们在管理FM症状和相关胃肠道疾病方面已显示出前景。文中讨论了维生素D、镁、维生素B12、辅酶Q10、益生菌、ω-3脂肪酸、褪黑素、S-腺苷甲硫氨酸和乙酰左旋肉碱等补充剂通过各种机制(包括抗炎作用、神经递质调节和线粒体功能改善)在FM管理中的潜在益处。总之,本综述强调了将神经营养作为FM治疗的整体方法的重要性,主张进行进一步的研究和临床试验,以建立全面的饮食指南并优化FM患者的管理策略。