目的 研究全科诊疗模式结合度洛西汀对纤维肌痛综合征（FMS）患者心理状况、睡眠质量及血清炎性细胞因子的影响。 方法 采用随机数字表法将2019年1月至2021年12月承德市中心医院诊治的105例FMS患者分为联合组53例与对照组52例，分别接受全科诊疗模式结合度洛西汀治疗与单独度洛西汀治疗。1疗程4周，干预2疗程后评估疗效及安全性，治疗前后对患者行视觉模拟评分法（VAS）、汉密尔顿焦虑评估量表（HAMA）、汉密尔顿抑郁量表（HAMD）及匹兹堡睡眠质量指数量表（PSQI），评估患者疼痛、心理状况及睡眠质量，另抽血测定治疗前后血清肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1、IL-6水平。 结果 研究组总有效率96.23%高于对照组的82.69%（P < 0.05）。对比治疗前，两组患者治疗后VAS、HAMA、HAMD及PSQI评分、血清TNF-α、IL-1及IL-6水平均下降，且研究组均低于对照组（P < 0.05）。研究组不良反应发生率7.55%，与对照组的19.23%对比差异无统计学意义（P > 0.05）。 结论 全科诊疗模式结合度洛西汀治疗FMS安全有效，能明显缓解患者焦虑抑郁情绪，改善其睡眠质量，降低血清炎性细胞因子水平。

Objective The aim of this study was to investigate the effects of general practice mode combined with duloxetine on psychological status， sleep quality and serum inflammatory cytokines in patients with Fibromyalgia Syndrome （FMS）. Methods A total of 105 FMS patients in Chengde Central Hospital from January 2019 to December 2021 were divided into the combined group （53 cases） and the control group （52 cases） by the random number table method. The two groups were treated with general practice mode combined with duloxetine or duloxetine alone. The single course of treatment lasted for 4 weeks. Their efficacy and safety were evaluated after 2 courses of intervention. Visual analogue scale （VAS）， Hamilton Anxiety assessment scale （HAMA）， Hamilton Depression Scale （HAMD） and Pittsburgh Sleep Quality Index （PSQI） were performed before and after treatment. The pain， psychological status and sleep quality of the patients were evaluated. Blood samples were taken to measure the serum levels of tumor necrosis factor?α （TNF?α）， interleukin?1 （IL?1） and IL?6 before and after treatment. Results The total effective rate in the study group was 96.23%， which was higher than that in the control group （82.69%， P < 0.05）. Compared with those before treatment， VAS， HAMA， HAMD and PSQI scores， serum TNF?α， IL?1 and IL-6 levels in the two groups were all decreased after treatment， and those in the study group were lower than those in the control group （P < 0.05）. There was no statistically significant difference in the incidence of adverse reactions between two groups （7.55% vs. 19.23%， P > 0.05）. Conclusion General practice mode combined with duloxetine was safe and effective in the treatment of FMS， which could significantly relieve anxiety and depression of patients， improve their sleep quality， and reduce the level of serum inflammatory cytokines.