"医学难以解释的症状"面临的挑战及对策

doi:10.12114/j.issn.1007-9572.2024.0153

摘要/Abstract

摘要： 医学难以解释的症状（medically unexplained symptoms，MUS）诊疗过程复杂，对医疗资源的耗费较大，是全科医学中具有挑战的临床问题，我国在该领域还处于初步探索阶段。本文从MUS的概念、流行病学特点、发生机制、诊断及治疗等方面系统、全面地探讨了MUS目前面临的挑战，并结合实际情况针对性地提出了一些可能的对策。目前，MUS的概念、机制及诊断路径均无统一定论，提示起草相关临床诊疗指南、构建临床路径的迫切需求；全科医生对MUS的了解及诊疗能力不足，需加强全科医生MUS岗位胜任能力培训，同时开展更多前瞻性、多中心、多学科联动的科学研究以探索MUS的特点及诊疗对策。本文可为全科医生更深入了解并科学且有效地管理MUS提供参考。

关键词: 医学难以解释的症状, 全科医学, 全科医生, 认知行为疗法, 挑战, 对策

Abstract:

The diagnosis and treatment of medically unexplained symptoms (MUS) is complex and the cost of medical resources is large. MUS is a challenging clinical problem in general practice. The field of MUS is still in the preliminary stage of exploration in China. In this review, we systematically and comprehensively discuss the current challenges of MUS in the aspects of the concept, epidemiological characteristics, pathogenesis, diagnosis and treatment. We also propose some possible countermeasures combined with the actual situation. This article shows that there is no consensus on the concept, mechanism and diagnostic of MUS, suggesting the urgent need to draft relevant clinical guidelines and construct clinical pathways. At present, general practitioners have insufficient ability in the understanding, diagnosis and treatment of MUS, therefore, it is necessary to strengthen the training of MUS competence for general practitioners. More prospective, multi-center and multidisciplinary studies are needed to explore the characteristics and treatment strategies of MUS. This article provides a reference for general practitioners to understand and manage MUS scientifically and effectively.

Key words: Medically unexplained symptoms, General practice, General practitioner, Cognitive behavior therapies, Challenge, Countermeasure

中图分类号:

R 197

庞姝,刁洋,陈祥雪,等. "医学难以解释的症状"面临的挑战及对策[J]. 中国全科医学, 2025, 28(07): 807-813. DOI: 10.12114/j.issn.1007-9572.2024.0153.
PANG Shu,DIAO Yang,CHEN Xiangxue, et al. Challenges and Countermeasures of Medically Unexplained Symptoms[J]. Chinese General Practice, 2025, 28(07): 807-813. DOI: 10.12114/j.issn.1007-9572.2024.0153.

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