Синдром хронической распространенной боли -новая междисциплинарная проблема или компетенция врача общей практики?
- Авторы: Колоколов О.В1, Ситкали И.В1, Шахпазов С.Ж1, Колоколова А.М1
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Учреждения:
- Саратовский ГМУ им. В.И. Разумовского Минздрава России
- Выпуск: № 5 (2018)
- Страницы: 71-80
- Раздел: Статьи
- URL: https://journals.eco-vector.com/2073-4034/article/view/295312
- DOI: https://doi.org/10.18565/pharmateca.2018.5.71-80
- ID: 295312
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Аннотация
В статье обсуждается актуальная проблема дифференциальной диагностики и лечения заболеваний, проявляющихся синдромом хронической распространенной боли (ХРБ). Перечислены международные критерии клинической диагностики фибромиалгии (ФМ) - основного заболевания, характеризующегося ХРБ. Приведены сведения об эпидемиологии и патогенезе ХРБ и ФМ. Подчеркнуто, что грамотная клиническая оценка для уточнения причин ХРБ имеет большее значение, нежели дополнительная диагностика. Диагноз ФМ может быть установлен в условиях учреждений, оказывающих первичную медико-санитарную помощь, на основании оценки соответствия критериям The American College of Rheumatology (ACR, 2010) при условии нормальных результатов объективного осмотра и рутинных лабораторных тестов, исключающих другие заболевания. Указаны основные группы заболеваний, которые надо иметь в виду во время диагностического поиска при выявлении ХРБ: болезни костно-мышечной системы и соединительной ткани, эндокринологические, гастроэнтерологические, инфекционные, онкологические заболевания, неврологические расстройства, нарушения психического здоровья, ятрогенная боль. Особое внимание уделено анкилозирующему спондилоартриту и миофасциальному болевому синдрому. Обсуждаются проблемы лечения ФМ.
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Об авторах
О. В Колоколов
Саратовский ГМУ им. В.И. Разумовского Минздрава России
Email: kolokolov@inbox.ru
д.м.н.
И. В Ситкали
Саратовский ГМУ им. В.И. Разумовского Минздрава России
С. Ж Шахпазов
Саратовский ГМУ им. В.И. Разумовского Минздрава России
А. М Колоколова
Саратовский ГМУ им. В.И. Разумовского Минздрава России
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