慢性疲劳综合征的临床特征与研究进展

Clinical features and updated research of chronic fatigue syndrome

目的:慢性疲劳综合征(chronicfatiguesyndrome,CFS)是一组以疲劳为主的综合症候群,大多数给不出确切的病理解剖学诊断。研究CFS以利于临床医生对本疾病足够重视,以便正确诊断,早期干预,促进CFS患者早日康复。资料来源:以“慢性疲劳综合征”为主题词全面检索美国国家图书馆医学在线(Medline)数据库和万方数据库,获取CFS的全部资料和信息。资料选择:对获取的资料以“intitle”、“2000/2004”加以限制,筛选出近5年的主题文献,并对重点文献的主要参考文献进行手工检索追踪相关全文。文献包括基础研究和临床研究。资料提炼:37篇关于CFS的文献,29篇符合标准,排除的8篇文献是重复的同一研究,对剩余的29篇关于CFS主题文献全文中的相关信息进行分类综合研究。资料综合:CFS主要表现为持续或反复发作的疲劳和躯体疼痛、失眠、情绪抑郁和免疫功能异常。临床检查多无明显器质性改变。就其病因主要有两种学说:生物感染和由感染直接介导的免疫功能失调,另外,可能与神经内分泌紊乱、营养物缺乏、过度劳累、心理等因素相关。CFS与纤维肌痛综合征、肌纤维疼痛综合征、抑郁症等部分交叉和重叠。CFS的治疗方法很多,如药物治疗、营养支持、行为认知疗法和有氧运动疗法等,但都是非特异性的。结论:研究表明应该针对不同的患病?

OBJECTIVE:Chronic fatigue syndrome(CFS) is a series of symptoms characterized by a condition-related fatigue,whose pathophysiological and anatomical diagnosis can not beaccounted for mostly Based on the study of clinical features of CFS,clinicians can pay enough attention to CFS so that correct diagnosis and early intervention are possible,which might lead to better chance of recovery. DATA SOURCES:A search through MEDLINE database and Wanfang database was made with the keyword “chronic fatigue syndrome'. STUDY SELECTION:The search range was limited with “in title' and “2000/2004' in order to gather all the key papers in the last five years.Full texts of very important papers that list in the references were acquired by manual search.References in both fundamental research and clinical research were gathered. DATA EXTRACTION:Eight papers about similar topic were excluded,29 of the 37 papers about CFS were extracted and analyzed in groups to consult the related information in the whole contents. DATA SYNTHESIS:The major symptoms of CFS are persisting or recurring fatigue,sleeping disturbance,depression and immunological dysfunction.The diagnosis can be made only after alternative medical and psychiatric causes of chronic fatiguing illness have been excluded.Two major causative theories of CFS are viral infection or immunological disorder that may be induced by infection.The other causes of CFS may involve neuroendocrine disturbance,nutrition deficiency,overfatigue,physical or emotional stress,etc.The clinical features of CFS are partly crossed or overlaped with fibromyalgia,myofascial pain syndrome and depression.The alternative treatment of CFS may involve pharmacologic therapy,nutritional support,cognitive behavior therapy and aerobics exercise.These,however,are all non-specific. CONCLUSION:It is suggested that in order to achieve better curative effect,the treatment for CFS should be individual-oriented or combinational.