慢性疲勞及其症候群

Chronic Fatigue and Its Syndromes

施嫈瑜(Ying-Yu Shih) ； 林易賢(I-Hsien Lin) ； 蘇昭儒(Jan-Ru Su) ； 鄭振鴻(Chen-Hung Cheng) ； 李世代(Shyh-Dye Lee) ； 郭聖達(San-Dar Kuo)

《北市醫學雜誌》 2卷12期 (2005/12) Pp. 1082-1088

https://doi.org/10.6200/TCMJ.2005.2.12.01

摘要

慢性疲勞為基層醫療最常見的症狀之一。本篇以實證醫學方式，將慢性疲勞及其症候群的診斷治療做縱論。診斷以臨床病史、排除其他疾病為主，與憂鬱症、大腸急躁症與纖維肌痛等有共病現象。其病理機轉尚未明瞭，目前以精神－神經－免疫失調學說為主。沒有藥物被證實可以長期改善或治療此病，藥物的使用在於緩解症狀及提升生活品質。認知行為治療與分級鍛鍊運動可能可以有效地治療部分的病患。非特異性、難以解釋的疾患相當普遍。為提供病患整體而有效的診療照護，臨床醫師應提升對此致病模式的警覺，並積極介入其源發的身心社會壓力因素。

關鍵字

慢性疲勞 ； 機能性身體化症候群 ； 共病 ； 生理 ； 心理 ； 社會模式

並列摘要

Chronic fatigue is one of the most common symptoms in primary care. This article is an overview of chronic fatigue and its syndromes (CFS) based on evidence-based clinical practice. The diagnosis of CFS relies on clinical evidence and exclusion of alternative medical or psychiatric diseases. The symptoms may overlap with depression, irritable-bowel-syndrome and fibromyalgia. The symptoms are thought to be the result of a disturbed psycho-neuro-immunological function but the underlying pathophysiology is not known. No medication has yet been shown to provide long-term remission or ”cure” for patients with CFS. Medication is used to relieve distress and promote quality of life. Cognitive-behavior treatment and graded exercise may be effective for some patients with CFS. Non-specific and medically unexplained illnesses are common in practice. To provide patients with comprehensive and efficient treatment, physicians should facilitate knowledge of stress-related health problems and explore high risk patients using bio-psycho-social models.

並列關鍵字

chronic fatigue ； functional somatic syndrome ； co-morbidity ； bio-psycho-social model