药片之外:纤维肌痛治疗中药理和体育锻炼干预的协同作用。综述

Oliwia Bochenek, Mateusz Koper, Aleksandra Nowak, Jessica Kałuża, Adrian Konaszczuk, Klaudia Ratyna, Oliwia Kozyra, Zofia Szypuła, Katarzyna Paluch, M. Skarbek
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摘要

引言和目的 纤维肌痛(FM)是一种慢性疾病,以广泛的肌肉骨骼疼痛、疲劳、睡眠障碍和认知功能障碍为特征,影响着全球 2%-4% 的人口,在女性和社会经济地位较低的人群中发病率较高。FM 的发病机制复杂且多因素,涉及中枢敏化和神经化学失调。本综述重点介绍纤维肌痛的药物和行为疗法的最新进展。知识现状 目前,纤维肌痛的治疗主要基于药物治疗和非药物治疗相结合的方法,其中非药物治疗主要基于体育锻炼和认知行为疗法。本综述探讨了纤维肌痛治疗方法的进展,重点关注新型药理药物,如伏替西汀、醋酸艾司卡西平和他喷他多,这些药物可通过靶向特定的神经化学通路来缓解症状。伏替西汀提供了具有潜在认知益处的新作用机制,而醋酸艾司卡西平和他喷他多则提供了疼痛调节和中枢敏化的替代方法。此外,包括高强度间歇训练(HIIT)和虚拟现实(VR)疗法在内的非药物疗法在增强 FM 患者体能、减轻疼痛和提高生活质量方面也大有可为。小结 总的来说,将这些新型疗法融入全面的个性化治疗计划中,可以优化治疗效果,提高 FM 患者的生活质量。持续的研究和个性化医疗方法对于进一步完善和验证这些新兴疗法至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beyond Pills: Synergizing Pharmacological and Physical Activity Interventions in Fibromyalgia Treatment. A review
Introduction and purpose Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive impairment, affecting 2-4% of the global population, with a higher prevalence among women and those of lower socioeconomic status. The pathogenesis of FM is complex and multifactorial, involving central sensitization and neurochemical dysregulation. This review highlights the latest advancements in pharmacological and behavioral therapies for fibromyalgia. State of knowledge Management of fibromyalgia currently is based on a combination of medication use and non-pharmacological approaches, primarily based on physical activity and cognitive-behavioral therapy. This review explores advancements in FM treatments, focusing on novel pharmacological agents such as vortioxetine, eslicarbazepine acetate, and tapentadol, which target specific neurochemical pathways to alleviate symptoms. Vortioxetine offers new mechanisms of action with potential cognitive benefits, while eslicarbazepine acetate and tapentadol provide alternative approaches for pain modulation and central sensitization. Additionally, non-pharmacological therapies, including high-intensity interval training (HIIT) and virtual reality (VR) therapy, demonstrate promise in enhancing physical fitness, reducing pain, and improving quality of life for FM patients. Summary Overall, the integration of these novel therapies into comprehensive, individualized treatment plans can optimize outcomes and enhance the quality of life for individuals with FM. Ongoing research and personalized medicine approaches are essential to further refine and validate these emerging treatments.
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