Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital, Kirrberger Straße 100, D-66421 Homburg/Saar, Germany.
BMC Musculoskelet Disord. 2011 Jun 15;12:133. doi: 10.1186/1471-2474-12-133.
Recent systematic reviews on psychological therapies of fibromyalgia syndrome (FMS) did not consider hypnosis/guided imagery (H/GI). Therefore we performed a systematic review with meta-analysis of the efficacy of H/GI in FMS.
We screened http://ClinicalTrials.gov, Cochrane Library, MEDLINE, PsycINFO and SCOPUS (through December 2010). (Quasi-) randomized controlled trials (CTs) comparing H/GI with controls were analyzed. Outcomes were pain, sleep, fatigue, depressed mood and health-related quality of life (HRQOL). Effects were summarized using standardized mean differences (SMD).
Six CTs with 239 subjects with a median of 9 (range 7-12) H/GI-sessions were analysed. The median number of patients in the H/GI groups was 20 (range 8-26). Three studies performed follow-ups. H/GI reduced pain compared to controls at final treatment (SMD -1.17 [95% CI -2.21, -0.13]; p = 0.03). H/GI did not reduce limitations of HRQOL at final treatment (SMD -0.90 [95% CI -2.55, 0.76]; p = 0.29) compared to controls. Effect sizes on fatigue, sleep and depressed mood at final treatment and follow-up and on pain and HRQOL at follow-up were not calculated because of limited data available. The significant effect on pain at final treatment was associated with low methodological and low treatment quality.
Further studies with better treatment quality and adequate methodological quality assessing all key domains of FMS are necessary to clarify the efficacy of H/GI in FMS.
最近对纤维肌痛综合征（FMS）的心理治疗的系统评价没有考虑催眠/意象引导（H/GI）。因此，我们进行了一项系统评价和荟萃分析，以评估 H/GI 在 FMS 中的疗效。
我们在 http://ClinicalTrials.gov、Cochrane 图书馆、MEDLINE、PsycINFO 和 SCOPUS （截至 2010 年 12 月）进行了筛选。（准）随机对照试验（CTs）将 H/GI 与对照组进行比较。结果是疼痛、睡眠、疲劳、抑郁情绪和健康相关生活质量（HRQOL）。使用标准化均数差（SMD）总结效应。
分析了 6 项共 239 例患者的 CT 研究，中位数 H/GI 疗程为 9 次（范围 7-12 次）。H/GI 组的中位数患者数为 20 例（范围 8-26 例）。3 项研究进行了随访。与对照组相比，H/GI 在最终治疗时降低了疼痛（SMD-1.17 [95%CI-2.21，-0.13]；p=0.03）。与对照组相比，H/GI 并未降低最终治疗时 HRQOL 的限制（SMD-0.90 [95%CI-2.55，0.76]；p=0.29）。由于数据有限，未计算最终治疗和随访时的疲劳、睡眠和抑郁情绪以及随访时的疼痛和 HRQOL 的效应大小。最终治疗时疼痛的显著疗效与低方法学和低治疗质量相关。
需要进行更多具有更好治疗质量和充分方法学质量评估 FMS 所有关键领域的研究，以明确 H/GI 在 FMS 中的疗效。
