Синдром хронической распространенной боли – новая междисциплинарная проблема или компетенция врача общей практики?


DOI: https://dx.doi.org/10.18565/pharmateca.2018.5.71-80

О.В. Колоколов, И.В. Ситкали, С.Ж. Шахпазов, А.М. Колоколова

Саратовский ГМУ им. В.И. Разумовского Минздрава России, Саратов, Россия
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 / Для корреспонденции


Автор для связи: О.В. Колоколов – д.м.н., Саратовский ГМУ им. В.И. Разумовского Минздрава России, Саратов, Россия; e-mail: kolokolov@inbox.ru, ORCID: https://orcid.org/0000-0001-6672-6873


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