顽固的痛风——影响躯体疾病的心理行为因素  

Stubborn Gout:Psychological and Behavioral Factors Affecting Physical Diseases

作　　者：李佳蕊 陈丽霞 李涛[1] 姜忆南 张上珠[3] 王曦[4] 崔旭蕾[5] 王含[6] 李晓青[7] 魏镜[1] LI Jiarui;CHEN Lixia;LI Tao;JIANG Yinan;ZHANG Shangzhu;WANG Xi;CUI Xulei;WANG Han;LI Xiaoqing;WEI Jing(Department of Psychological Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Physical Medicine&Rehabilitation,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Rheumatology and Clinical Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Neurology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院心理医学科,北京100730 [2]中国医学科学院北京协和医院康复医学科,北京100730 [3]中国医学科学院北京协和医院风湿免疫科,北京100730 [4]中国医学科学院北京协和医院内分泌科,北京100730 [5]中国医学科学院北京协和医院麻醉科,北京100730 [6]中国医学科学院北京协和医院神经科,北京100730 [7]中国医学科学院北京协和医院消化内科,北京100730

出　　处：《协和医学杂志》2024年第5期1204-1210,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：科技创新2030(2021ZD0202001);中央高水平医院临床科研专项(2022⁃PUMCH⁃A⁃180)。

摘　　要：患者中年男性,疼痛对其生活产生显著影响,曾于外院反复诊治,效果均不佳。因“多发关节疼痛10余年,加重伴情绪不稳5年”至北京协和医院门诊就诊,经多学科团队讨论后,明确该患者疼痛主要由痛风引发,其久治不愈与心理社会因素关系密切,符合“影响躯体疾病的心理行为因素”这一诊断。在此基础上,对患者进行多学科综合管理,识别和处理影响躯体疾病的心理行为因素,其症状显著改善。该例患者的临床诊治体现了躯体症状(障碍)多学科协作诊疗的重要价值。A middle⁃aged male came to Peking Union Medical College Hospital for treatment because of“pain for 10+years,aggravated with emotional instability for 5 years”.The patient's pain had a huge impact on life,with poor results even after repeated diagnosis and treatment in other hospitals.After multi⁃disciplinary discussion,it had been clarified that the pain was mainly caused by gout.The disease was heavily influenced by psychosocial factors.Therefore,the patient fits the diagnosis of“Psychological and Behavioral Factors Affecting Physical Diseases”.The multi⁃disciplinary comprehensive management of the patient was carried out to identify and treat psychological factors affecting other medical conditions.After this mental treatment was performed,the patient's conditions significantly improved.The diagnosis and treatment of this patient demonstrates the importance of the multi⁃disciplinary treatment team for somatic symptoms(disorders).

关 键 词：慢性疼痛 影响躯体疾病的心理行为因素 痛风 多学科协作诊疗 

分 类 号：R395.1[哲学宗教—心理学] R395.5[医药卫生—医学心理学] R684.3[医药卫生—基础医学]