Li Xuanlin, Pan Hejing, Wang Liaoyao, Zhou Qi, Ma Yanfang, Wang Qi, Wang Mingzhu, Xie Zhijun, Li Haichang, Chen Lu, Huang Lin, Chen Yaolong, Wen Chengping
School of Basic Medical Sciences of Zhejiang Chinese Medical University, Hangzhou, China.
The Wuyun Mountain Hospital of Hangzhou (The Health Promotion Institute of Hangzhou), Hangzhou, China.
J Evid Based Med. 2025 Jun;18(2):e70044. doi: 10.1111/jebm.70044.
Fibromyalgia is a prevalent chronic condition marked by widespread pain, fatigue, and other debilitating symptoms. This guideline provides evidence-based recommendations for nonpharmacological treatments, developed by a multidisciplinary expert group, including specialists in rheumatology, rehabilitation, pain management, traditional Chinese medicine (TCM), and evidence-based medicine. The guideline follows the RIGHT checklist and is registered with the International Practice Guideline Registry Platform. The literature review incorporates systematic reviews, meta-analyses, and randomized controlled trials (RCTs) up to March 2023, focusing on the effects of nonpharmacological interventions on pain intensity, fatigue, sleep quality, mood, and quality of life. A total of 57 studies were included, with findings supporting acupuncture and health education as core therapies. These interventions significantly reduce pain, alleviate fatigue, and improve sleep quality, and are strongly recommended based on moderate-quality evidence. Additionally, aerobic exercise and resistance training are recommended for their proven effectiveness in reducing pain, enhancing physical function, and providing long-term benefits. Emerging therapies, such as transcranial magnetic stimulation (TMS) and nutritional supplements, show promise but require further research due to low-certainty evidence.
纤维肌痛是一种常见的慢性疾病,其特征为全身疼痛、疲劳及其他使人衰弱的症状。本指南为由多学科专家组制定的非药物治疗提供循证建议,该专家组包括风湿病学、康复医学、疼痛管理、中医及循证医学方面的专家。本指南遵循RIGHT清单,并已在国际实践指南注册平台注册。文献综述纳入了截至2023年3月的系统评价、荟萃分析和随机对照试验(RCT),重点关注非药物干预对疼痛强度、疲劳、睡眠质量、情绪和生活质量的影响。共纳入57项研究,结果支持针灸和健康教育作为核心疗法。这些干预措施能显著减轻疼痛、缓解疲劳并改善睡眠质量,基于中等质量的证据被强烈推荐。此外,有氧运动和抗阻训练因其在减轻疼痛、增强身体功能及提供长期益处方面的已证实效果而被推荐。新兴疗法,如经颅磁刺激(TMS)和营养补充剂,虽显示出前景,但由于证据确定性低,需要进一步研究。