未分化疾病全科诊疗思维:消瘦1例  

Diagnosis and treatment of MUPS:a general practice perspective on involuntary weight loss

作　　者：姚丁烨 罗桂平 孙俊生 马方晖 任菁菁[4] YAO Dingye;LUO Guiping;SUN Junsheng;MA Fanghui;REN Jingjing(Department of General Practice,Longgang Central Hospital,Shantou University Medical College,Shenzhen,Guangdong 518116,China;不详)

机构地区：[1]汕头大学医学院附属龙岗中心医院全科医学科,广东深圳518116 [2]广州中医药大学深圳临床医学院全科医学科,广东深圳518116 [3]深圳市龙岗区人民医院中央悦城社区健康服务中心,广东深圳518116 [4]浙江大学医学院附属第一医院全科医学科,浙江杭州311103

出　　处：《中华全科医学》2025年第3期534-538,共5页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(72274169);广东省本科高校教学质量与教学改革工程项目[粤教高函〔2023〕4号];广东省深圳市龙岗区医学学科建设经费资助项目;汕头大学医学院本科教学改革与研究项目(24JXGG05)。

摘　　要：消瘦是全科医学门诊常见的未分化疾病之一,病因复杂,各系统疾病均可导致消瘦的发生。患者常辗转多个科室就诊未得到诊断及管理,浪费大量医疗资源的同时也给患者身心造成困扰。本文通过分析1例就诊多个科室未明确诊断,全科门诊通过莫塔安全策略、RICE问诊等全科诊疗工具,最终确诊为微笑型抑郁症的患者,旨在提高全科医生对消瘦的认识,门诊接诊患者时善用全科特有的诊疗工具进行分析判断。Involuntary weight loss is one of the common medically unexplained physical symptoms(MUPS)in general practice clinic,and it's aetiology is complex,with various system diseases leading to involuntary weight loss.Patients are often referred to many departments without diagnosis and management,which not only wastes a lot of medical resources,but also causes physical and mental distress to patients.This article analyses the case of a patient who was not diagnosed and treated in several departments,but was finally diagnosed with smile-type depression in general practice clinic:using general practice diagnostic tools such as John Murtagh's safe diagnostic strategy and RICE inquiring.The aim of this article is to raise general practitioners'understanding of involuntary weight loss and to make good use of the unique diagnostic tools of general practice in analysing and assessing patients in general practice clinic.

关 键 词：消瘦 抑郁症 莫塔安全策略 全科医学 

分 类 号：R499[医药卫生—康复医学] R589.2[医药卫生—临床医学] R749.4