Astin John A
California Pacific Medical Center Research Institute, San Francisco, CA, USA.
Clin J Pain. 2004 Jan-Feb;20(1):27-32. doi: 10.1097/00002508-200401000-00006.
This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures.
本文综述了身心疗法（如放松、冥想、意象、认知行为疗法）在治疗与疼痛相关的医学病症方面的证据，并提出了这些领域未来研究的方向。基于随机对照试验的证据，以及在许多情况下对文献的系统综述，可提出以下建议：1）包括压力管理、应对技能训练、认知重构和放松疗法等某种组合的多成分身心方法，可能是慢性下腰痛的一种合适辅助治疗方法；2）多模式身心方法，如认知行为疗法，特别是与教育/信息成分相结合时，可成为类风湿性关节炎和骨关节炎管理的有效辅助手段；3）放松和热生物反馈可被视为复发性偏头痛的一种治疗方法，而放松和肌肉生物反馈可成为复发性紧张性头痛的有效辅助或独立治疗方法；4）一系列身心疗法（如意象、催眠、放松）在手术前使用时，可缩短恢复时间并减轻手术后的疼痛；5）身心方法可被视为辅助疗法，以帮助减轻侵入性医疗程序中的疼痛。
