ABSTRACT
Objective:To investigate the currentstatus of the diagnosis of fibromyalgia syndrome (FMS), and analyze the related factors in order to improve the diagnostic level of the disease.Methods:A survey was carried out, A "FMS diagnosis table" was developed. The demographic data and past medical experience of patients were recorded. The rates of misdiagnosis and missed diagnosis were calculated. The specific misdiagnosed cases were recorded and analyzed. According to the previous diagnosis history, patients were divided into misdiagnosed group, missed diagnosis group and correct diagnosis group. The demographic characteristics, medical history and disease severity in the misdiagnosis group and missed diagnosis group were statistically analyzed, and compared with the correct diagnosis group. The reasons for missed diagnosis or misdiagnosis were explored.Results:A total of 277 patients were included in the survey. Only 19.1%(53 cases) of patients were correctly diagnosed, 22.7%(63 cases) of patients were misdiagnosed, 58.1% of patients were missed. The mean time from first symptom to disease diagnosis was (51.0±81.2) months. They were often misdiagnosed as osteoarthritis ( n=21, 33.3%), rheumatoid arthritis ( n=13, 20.6%), lumbar disease ( n=12, 19.0%), and anxiety and depression ( n=11, 17.4%). Patients' social and economic status such as age, income, educational level and the diagnosis level of pain related clinicians in medical institutions at all levels were factors that might influence misdiagnosis and missed diagnosis rate. In terms of demographic characteristics, the correctly diagnosed group had a lower average age of (44±13) years ( t=8.64/9.20, P<0.05), a higher proportion of employees, a higher monthly income ( χ2=7.10/6.87, P<0.05), and a higher education level ( χ2=7.12, P<0.05). In terms of visits, the rate of visits to other medical institutions (private hospitals) in the missed diagnosis group was higher, and the number of doctors visited was also lower. In terms of illness, the diffuse pain index (WPI) score and FMS symptom severity (SSS) score were lower in the missed diagnosis group. Conclusion:The current situation of the diagnosis of FMS in China is not optimistic, and the diagnosis should be differentiated from osteoarthritis, rheumatoid arthritis, cervical and lumbar diseases, and cardiac diseases. In order to reduce the misdiagnosis and missed diagnosis of this disease, it is necessary to strengthen the public education, improve the understanding of this disease in primary care doctors, and physicians in orthopedics, acupuncture and pain departments.
ABSTRACT
Objective:To study the relationship between the levels of serum insulin,C-reactive protein(CRP),Tumor Necrosis Factor(TNF-?),insulin resistance index,blood fat,and phlegm-stagnation stasis syndrome of metabolic syndrome(MS),so as to discuss the signifi cance of phlegm-stagnation stasis syndrome in treatment based on syndrome differentiation of MS,in order to fi nd the objective evidence of differentiation of symptoms and signs of TCM of MS.Methods: In this study,54 cases with MS were divided into groups of phlegm-stagnation stasis syndrome and non-phlegm-stagnation stasis syndrome according to the clinical symptoms,tongue demonstration and pulse tracings.There were 25 cases in phlegm-stagnation stasis group,29 cases in non-phlegm-stagnation stasis group.The levels of serum insulin,CRP,TNF-?,blood fat were checked,the insulin resistance index was calculated.Results:The levels of serum insulin,CRP,TNF-? of the two groups of metabolic syndrome were signifi cantly higher than those of the healthy persons(P