Clinical Pathway of Medically Unexplained Physical Symptoms in Primary Care：Low Back Pain

doi:10.12114/j.issn.1007-9572.2019.01.024

Abstract

Abstract:

medically unexplained physical symptoms（MUPS） are physical symptoms which cannot be explained well or in the early stage of a certain disease. Low back pain is a common MUPS with characteristics of high prevalence，high recurrence rate and high medical expenditure，linking to many diseases. Moreover，it can seriously affect people's quality of life and bring about great burdens on families and society. We did a review of the articles，clinical guidelines and expert consensuses regarding low back pain that were searched from databases of CNKI，WANFANG DATA，PubMed，and Web of Science. And based on this，we detailed the types，diagnosis and management of low back pain from a general practitioner's perspective，and developed a clinical pathway for low back pain suitable for GPs using an experimental approach，aiming to provide a clear thought process of low back pain management for GPs，optimize the procedure of low back pain management，and contributing to the achievement of hierarchical diagnosis and treatment and bidirectional referrals.

Key words: Low back pain, Medically unexplained physical symptoms, Clinical pathway, Two-way referral

摘要： 未分化疾病是指医学上无法解释的躯体症状或指疾病早期尚未明确归属于某一系统的疾病，腰痛作为常见的未分化疾病，具有高患病率、高复发率及高医疗支出等特点，且其涉及的相关疾病的种类较多，严重影响人们的生活质量，也给家庭和社会带来巨大的经济负担。本文通过检索中国知网、万方数据知识服务平台、PubMed、Web of Science等数据库中与腰痛相关的国内外文献、临床指南及专家共识等，从全科医生的视角，介绍腰痛的分类、诊断、管理等，探讨并尝试建立适用于全科医生的腰痛临床路径，旨在为全科医生提供清晰的腰痛管理思路，同时优化腰痛患者的管理，促进实现分级诊疗、双向转诊的有效开展。

关键词: 腰痛, 未分化疾病, 临床路径, 双向转诊

ZHU Xiaodan,LI Yanhua,LI Junwei. Clinical Pathway of Medically Unexplained Physical Symptoms in Primary Care：Low Back Pain　[J]. Chinese General Practice, 2019, 22(1): 117-122. DOI: 10.12114/j.issn.1007-9572.2019.01.024.
朱晓丹,李琰华,李俊伟. 以腰痛为表现的未分化疾病的基层临床路径[J]. 中国全科医学, 2019, 22(1): 117-122. DOI: 10.12114/j.issn.1007-9572.2019.01.024.

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