Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management
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DOI：
10.1016/j.mayocp.2021.07.004
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发表时间：
2021-11-01
影响因子：
8.9
通讯作者：
Yellman, Brayden P.
中科院分区：
文献类型：
--
作者：
Bateman, Lucinda;Bested, Alison C.;Yellman, Brayden P.
尽管肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)影响着全球数百万人，但许多临床医生缺乏适当诊断或处理ME/CFS的知识。不幸的是，临床指导一直是稀缺的、过时的或潜在的有害的。因此，在美国，高达91%的患者仍然没有得到诊断，而那些被诊断出来的患者经常得到不适当的治疗。这些问题变得越来越重要，因为在急性新冠肺炎之后，相当大比例的人仍然患有类似ME/CFS的疾病长达数月。2015年，美国国家医学院发布了新的循证临床诊断标准，美国疾病控制和预防中心已经采用了这些标准。此外，美国和其他政府以及主要的医疗保健组织最近已经取消了分级运动和认知行为疗法作为ME/CFS患者的首选治疗方法。最近，21名专门研究ME/CFS的临床医生聚集在一起，讨论对受ME/CFS影响的成年人的最佳临床实践。本文根据最新的科学进展和数十年的临床经验，总结了他们对多面手和专科医疗保健提供者的顶级建议。临床医生可以采取许多措施来改善ME/CFS患者的健康、功能和生活质量，包括那些在新冠肺炎之后发生ME/CFS的患者。不完全符合ME/CFS标准的急性新冠肺炎后遗症患者也可能从这些方法中受益。(C)2021年梅奥医学教育和研究基金会。由爱思唯尔公司出版。这是CC BY-NC-ND许可(http://creativecommons.org/licenses/by-nc-nd/4.0/)中心点Mayo Clin Proc下的一篇开放获取文章。2021；96(11)：2861-2878
Despite myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) affecting millions of people worldwide, many clinicians lack the knowledge to appropriately diagnose or manage ME/CFS. Unfortunately, clinical guidance has been scarce, obsolete, or potentially harmful. Consequently, up to 91% of patients in the United States remain undiagnosed, and those diagnosed often receive inappropriate treatment. These problems are of increasing importance because after acute COVID-19, a significant percentage of people remain ill for many months with an illness similar to ME/CFS. In 2015, the US National Academy of Medicine published new evidence-based clinical diagnostic criteria that have been adopted by the US Centers for Disease Control and Prevention. Furthermore, the United States and other governments as well as major health care organizations have recently withdrawn graded exercise and cognitive-behavioral therapy as the treatment of choice for patients with ME/CFS. Recently, 21 clinicians specializing in ME/CFS convened to discuss best clinical practices for adults affected by ME/CFS. This article summarizes their top recommendations for generalist and specialist health care providers based on recent scientific progress and decades of clinical experience. There are many steps that clinicians can take to improve the health, function, and quality of life of those with ME/CFS, including those in whom ME/CFS develops after COVID-19. Patients with a lingering illness that follows acute COVID-19 who do not fully meet criteria for ME/CFS may also benefit from these approaches. (c) 2021 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) center dot Mayo Clin Proc. 2021;96(11):2861-2878