Alfvén G, Lindstrom A
Paediatric Department, Huddinge Hospital, Stockholm, Sweden.
Acta Paediatr. 2007 Jan;96(1):76-81. doi: 10.1111/j.1651-2227.2006.00028.x.
To test the hypothesis that psychological treatment given in combination with somatic treatment can relieve recurrent abdominal pain (RAP) of psychosomatic origin in childhood.
Stomach Pain Clinic Group A, comprising 25 children receiving a combination of psychological treatment and physiotherapy given by two different persons and Stomach Pain Clinic Group B, comprising 23 children receiving physiotherapy only, were constituted in a randomized manner. Stomach Pain Clinic Group C, including 35 children receiving an integrated combination of psychological treatment and somatic treatment given by the same person was also constituted, as well as a reference group. Treatment outcome was measured by calculating a pain score and tender points (TP) score at inclusion and after 1 year.
The pain score after 1 year improved significantly in all four groups. Stomach Pain Clinic Groups A and B did not show any significant difference, but Stomach Pain Clinic C had a significantly better outcome than Stomach Pain Clinic Group B. Stomach Pain Clinic Groups A and C had a significant decrease in the TP score after 1 year. Pain scores and TP scores calculated for all Stomach Pain Clinic groups correlated significantly at follow-up after 1 year.
For children with psychosomatic RAP, a special method for integrated psychological and somatic treatment is probably effective. The results have to be confirmed in a randomized controlled study. These children have a special pattern of TPs related to their disorder, which diminishes with improvement in the disorder.
检验心理治疗与躯体治疗相结合可缓解儿童心身性复发性腹痛(RAP)这一假设。
随机组建胃痛诊所A组,包括25名接受由两名不同人员给予的心理治疗和物理治疗相结合的儿童,以及胃痛诊所B组,包括23名仅接受物理治疗的儿童。还组建了胃痛诊所C组,包括35名接受由同一人给予的心理治疗和躯体治疗综合治疗的儿童,以及一个参照组。通过在纳入时和1年后计算疼痛评分和压痛点(TP)评分来衡量治疗结果。
所有四组在1年后疼痛评分均显著改善。胃痛诊所A组和B组未显示出任何显著差异,但胃痛诊所C组的治疗结果明显优于胃痛诊所B组。胃痛诊所A组和C组在1年后TP评分显著降低。1年后随访时,所有胃痛诊所组计算的疼痛评分和TP评分显著相关。
对于患有心身性RAP的儿童,一种特殊的心理和躯体综合治疗方法可能有效。结果必须在随机对照研究中得到证实。这些儿童有一种与其疾病相关的特殊TP模式,随着疾病的改善而减少。