Center for Neurosensory Disorders, University of North Carolina, CB#7280, 3330 Thurston Building, Chapel Hill, NC 27599, USA.
Curr Rheumatol Rep. 2009 Dec;11(6):443-50. doi: 10.1007/s11926-009-0065-6.
This article considers four broad classes of psychological techniques and their effects on fibromyalgia (FM) pain. A literature search identified 14 randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT), five relaxation RCTs, five biofeedback RCTs, five hypnotherapy RCTs, and two writing intervention RCTs. For psychoanalytic therapy in FM, no RCTs have been published. The highest effect sizes (r = 0.53-2.14) for pain reduction are found after CBT and OBT group treatments. Relaxation as a single treatment has not been proven useful. Hypnotherapy and writing intervention have demonstrated mild treatment effects, whereas psychological treatment is effective in FM pain. Considering the heterogeneity of FM, the promising effects of matched interventions such as CBT and OBT with pharmacotherapy, exercise, and other treatment domains require further research.
本文考虑了四大类心理技术及其对纤维肌痛 (FM) 疼痛的影响。文献检索确定了 14 项认知行为疗法 (CBT) 和操作性行为疗法 (OBT) 的随机对照试验 (RCT)、5 项放松 RCT、5 项生物反馈 RCT、5 项催眠疗法 RCT 和 2 项写作干预 RCT。对于 FM 的精神分析疗法，尚未发表 RCT。在 CBT 和 OBT 组治疗后，发现疼痛减轻的最高效应量(r = 0.53-2.14)。单一的放松治疗没有被证明是有用的。催眠疗法和写作干预已显示出轻度的治疗效果，而心理治疗对 FM 疼痛有效。考虑到 FM 的异质性，需要进一步研究匹配干预措施，如 CBT 和 OBT 与药物治疗、运动和其他治疗领域的协同作用。
