Triantafyllias Konstantinos, Balaklytska Veronika, Sauer Charlotte, Dreher Matthias, Schwarting Andreas
Rheumazentrum Rheinland-Pfalz GmbH, Kaiser-Wilhelm-Str. 9-11, 55543, Bad Kreuznach, Deutschland.
Schwerpunkt Rheumatologie und klinische Immunologie, I. Med. Klinik und Poliklinik, Johannes Gutenberg Universitätsmedizin-Mainz, Mainz, Deutschland.
Z Rheumatol. 2025 Feb;84(1):10-18. doi: 10.1007/s00393-024-01568-x. Epub 2024 Sep 18.
Fibromyalgia syndrome (FMS) is a complex condition that is often refractory to therapy and is associated with impaired quality of life. In some studies, multimodal rheumatological treatment has been shown to be an effective therapy option for patients with systemic-inflammatory and degenerative rheumatic diseases. However, the effects of this therapeutic approach have not been sufficiently investigated in patients with FMS. Therefore, the aim of this study was to examine the effect of a concise 9‑ to 10-day inpatient multimodal fibromyalgia treatment (MFT) using patient-reported outcomes in a German cohort.
The effects of MFT were assessed using visual analog scales (VAS) for pain (P) and subjective disease activity (DA), questionnaires measuring everyday functional capacity (Health Assessment Questionnaire [HAQ], Funktions-Fragebogen-Hannover [FFbH, Hannover Functional Ability Questionnaire]), and pharmacotherapy at three time points (Visit 1: beginning of multimodal therapy, Visit 2: end of MFT, and Visit 3: 3 months after Visit 2).
Sixty-one patients were enrolled in the study at the Rhineland-Palatinate Acute Rheumatology Center. Under MFT, a significant improvement in VAS (P) and VAS (DA) was observed between the start and end of treatment (Visit 2 versus Visit 1: median decrease from 7 to 5, p < 0.001, for both VAS [P] and VAS [DA]). Additionally, comparison of the other two assessment points showed a change in VAS (P) (Visit 3 versus Visit 1: median decrease from 7 to 6, p = 0.041, and Visit 3 versus Visit 2: median increase from 5 to 6, p = 0.004). However, there were no significant differences in FFbH and HAQ parameters among the three visits. Examination of the subgroup of patients whose medication therapy was not intensified during hospitalization also showed significant improvements in VAS (P) and VAS (DA) between the start and end of MFB (Visit 2 versus Visit 1: median decrease from 7 to 4, p < 0.001, for VAS [P] and median decrease from 6.25 to 4, p = 0.002, for VAS [DA]).
These findings indicate a demonstrable benefit to patients of MFT regarding both pain and subjective disease activity. Furthermore, pain relief was even observed 3 months after the end of therapy. This shows the high value of this therapeutic approach to treating patients with FMS.
纤维肌痛综合征（FMS）是一种复杂病症，往往对治疗具有难治性，且与生活质量受损相关。在一些研究中，多模式风湿病治疗已被证明是治疗全身性炎症性和退行性风湿性疾病患者的有效治疗选择。然而，这种治疗方法在纤维肌痛综合征患者中的效果尚未得到充分研究。因此，本研究的目的是在一个德国队列中，使用患者报告的结果来检验为期9至10天的简明住院多模式纤维肌痛治疗（MFT）的效果。
使用视觉模拟量表（VAS）评估疼痛（P）和主观疾病活动度（DA）、测量日常功能能力的问卷（健康评估问卷[HAQ]、汉诺威功能能力问卷[FFbH]）以及在三个时间点的药物治疗，以此来评估MFT的效果（访视1：多模式治疗开始时，访视2：MFT结束时，访视3：访视2后3个月）。
61名患者在莱茵兰 - 普法尔茨州急性风湿病中心入组该研究。在MFT治疗下，治疗开始和结束之间观察到VAS（P）和VAS（DA）有显著改善（访视2与访视1相比：VAS[P]和VAS[DA]的中位数均从7降至5，p < 0.001）。此外，其他两个评估点的比较显示VAS（P）有变化（访视3与访视1相比：中位数从7降至6，p = 0.041；访视3与访视2相比：中位数从5升至6，p = 0.004）。然而，三次访视之间FFbH和HAQ参数没有显著差异。对住院期间药物治疗未强化的患者亚组进行检查也显示，MFB开始和结束之间VAS（P）和VAS（DA）有显著改善（访视2与访视1相比：VAS[P]中位数从7降至4，p < 0.001；VAS[DA]中位数从6.25降至4，p = 0.002）。
这些发现表明MFT对患者在疼痛和主观疾病活动度方面都有明显益处。此外，在治疗结束3个月后仍观察到疼痛缓解。这表明这种治疗方法对治疗纤维肌痛综合征患者具有很高的价值。
