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首页> 外文期刊>BMC Family Practice >Investigating unexplained fatigue in general practice with a particular focus on CFS/ME
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Investigating unexplained fatigue in general practice with a particular focus on CFS/ME

机译：在一般实践中研究无法解释的疲劳，特别关注CFS / ME

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Unexplained fatigue is not infrequent in the community. It presents a number of challenges to the primary care physician and particularly if the clinical examination and routine investigations are normal. However, while fatigue is a feature of many common illnesses, it is the main problem in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This is a poorly understood condition that is accompanied by several additional symptoms which suggest a subtle multisystem dysfunction. Not infrequently it is complicated by sleep disturbance and alterations in attention, memory and mood. Specialised services for the diagnosis and management of CFS/ME are markedly deficient in the UK and indeed in virtually all countries around the world. However, unexplained fatigue and CFS/ME may be confidently diagnosed on the basis of specific clinical criteria combined with the normality of routine blood tests. The latter include those that assess inflammation, autoimmunity, endocrine dysfunction and gluten sensitivity. Early diagnosis and intervention in general practice will do much to reduce patient anxiety, encourage improvement and prevent expensive unnecessary investigations. There is presently an on-going debate as to the precise criteria that best confirms CFS/ME to the exclusion of other medical and psychiatric/psychological causes of chronic fatigue. There is also some disagreement as to best means of investigating and managing this very challenging condition. Uncertainty here can contribute to patient stress which in some individuals can perpetuate and aggravate symptoms. A simple clinical scoring system and a short list of routine investigations should help discriminate CFS/ME from other causes of continued fatigue.
机译：无法解释的疲劳在社区中并不罕见。这给初级保健医生带来了许多挑战，尤其是在临床检查和常规检查正常的情况下。然而，尽管疲劳是许多常见疾病的特征，但它却是慢性疲劳综合症/肌病性脑脊髓炎（CFS / ME）的主要问题。这是一种鲜为人知的疾病，伴有一些其他症状，这些症状表明存在细微的多系统功能障碍。睡眠障碍以及注意力，记忆力和情绪的改变并不会很常见。在英国，乃至全世界几乎所有国家，用于诊断和管理CFS / ME的专业服务均明显不足。但是，可以根据特定的临床标准和常规血液检查的正常性，可靠地诊断出无法解释的疲劳和CFS / ME。后者包括那些评估炎症，自身免疫，内分泌功能障碍和面筋敏感性的物质。一般实践中的早期诊断和干预将在减少患者焦虑，鼓励改善和防止昂贵的不必要的调查方面起很大作用。目前，关于可以最好地证实CFS / ME的确切标准，而不是其他引起慢性疲劳的医学和精神病/心理原因，目前正在进行辩论。对于调查和管理这一极具挑战性的状况的最佳方法也存在一些分歧。这里的不确定性会加剧患者的压力，在某些人中，这种压力会长期存在并加重症状。简单的临床评分系统和简短的常规检查清单应有助于将CFS / ME与持续疲劳的其他原因区分开。

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