大转子疼痛综合征合并纤维肌痛一例及文献复习-东南大学学报医学版

大转子疼痛综合征合并纤维肌痛一例及文献复习

单位：1. 中国人民解放军总医院第一医学中心风湿病科, 北京 100853;
2. 中国人民解放军总医院第一医学中心医学心理科, 北京 100853;
3. 中国人民解放军总医院第一医学中心骨科, 北京 100853

分类号：R681.8;R749.92;R749.4

出版年·卷·期（页码）：2020·39·第五期（633-637）

摘要：

目的:了解器质性骨关节病常并发心理因素相关的纤维肌痛(FM),从而提高对“生物-心理-社会”整体医学模式的认识。方法:回顾性分析1例经临床诊断为大转子疼痛综合征(GTPS)并发FM患者的临床资料及诊疗过程,并复习相关文献。结果:患者起初诊断GTPS、髋关节骨关节炎,接受依托考昔等非甾体抗炎药治疗后病情改善不明显,后补充诊断FM,并加用盐酸度洛西汀等抗抑郁药物治疗后病情明显缓解。结论:器质性骨关节病可以并发心理因素相关的FM,导致疼痛等症状范围扩展,从而给诊断带来困难,应当予以重视。

Objective: To understand that organic osteoarthropathy were usually accompanied by fibromyalgia(FM), which was often associated with psychological factors, so as to improve the understanding of the overall medical model of “bio-psycho-social”. Methods: Clinical data and process of diagnosis and treatment in a patient who was clinically confirmed of greater trochanteric pain syndrome(GTPS) with FM was analyzed and the relevant literature was reviewed. Results: The patient was initially diagnosed with GTPS and hip osteoarthritis, but the condition was not significantly improved after receiving non-steroidal anti-inflammatory drugs such as etoricoxib. However, all of the symptoms were complete remission followed by a supplementary diagnosis of FM after treatment with anti-anxiety drugs such as duloxetine hydrochloride. Conclusion: Organic osteoarthropathy can be complicated with FM related to psychological factors, leading to the expansion of range of symptoms such as pain and difficulties in diagnosing, which should be paid serious attention.

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