Schaefert Rainer, Klose Petra, Moser Gabriele, Häuser Winfried
From the Department of General Internal Medicine and Psychosomatics (R.S.), University of Heidelberg, Heidelberg, Germany; Department of Internal and Integrative Medicine (P.K.), Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany; Department of Internal Medicine III (G.M.), Medical University of Vienna, Vienna, Austria; Department of Internal Medicine I (W.H.), Klinikum Saarbrücken, Saarbrücken, Germany; and Department of Psychosomatic Medicine (W.H.), Technische Universität München, München, Germany.
Psychosom Med. 2014 Jun;76(5):389-98. doi: 10.1097/PSY.0000000000000039.
To assess the efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome by a meta-analysis of randomized controlled trials.
Studies were identified by a literature search of the databases Allied and Complementary Medicine Database, Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycINFO, and Scopus (from inception to June 30, 2013). Primary outcomes were adequate symptom relief, global gastrointestinal score, and safety. Summary relative risks (RRs) with number needed to treat (NNT) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using random-effects models.
Eight randomized controlled trials with a total of 464 patients and a median of 8.5 (7-12) hypnosis sessions over a median of 12 (5-12) weeks were included into the analysis. At the end of therapy, hypnosis was superior to control conditions in producing adequate symptom relief (RR, 1.69 [95% CI = 1.14-2.51]; NNT, 5 [3-10]) and in reducing global gastrointestinal score (SMD, 0.32 [95% CI = -0.56 to -0.08]). At long-term follow-up, hypnosis was superior to controls in adequate symptom relief (RR, 2.17 [95% CI = 1.22-3.87]; NNT, 3 [2-10]), but not in reducing global gastrointestinal score (SMD, -0.57 [-1.40 to 0.26]). One (0.4%) of 238 patients in the hypnosis group dropped out due to an adverse event (panic attack).
This meta-analysis demonstrated that hypnosis was safe and provided long-term adequate symptom relief in 54% of patients with irritable bowel syndrome refractory to conventional therapy.
通过对随机对照试验的荟萃分析，评估催眠疗法对成人肠易激综合征的疗效、耐受性和安全性。
通过检索联合与补充医学数据库、对照试验中央注册库、护理及相关健康文献累积索引、PubMed、PsycINFO和Scopus数据库（从建库至2013年6月30日）来识别研究。主要结局为症状充分缓解、整体胃肠道评分和安全性。采用随机效应模型计算汇总相对危险度（RRs）及治疗所需人数（NNT），以及标准化均数差（SMDs）及其95%置信区间（95% CIs）。
八项随机对照试验共纳入464例患者，在为期12周（5 - 12周）的治疗中，催眠治疗 sessions 的中位数为8.5次（7 - 12次）。治疗结束时，催眠疗法在实现症状充分缓解方面优于对照疗法（RR，1.69 [95% CI = 1.14 - 2.51]；NNT，5 [3 - 10]），在降低整体胃肠道评分方面也更优（SMD，0.32 [95% CI = -0.56至 -0.08]）。在长期随访中，催眠疗法在症状充分缓解方面优于对照组（RR，2.17 [95% CI = 1.22 - 3.87]；NNT，3 [2 - 10]），但在降低整体胃肠道评分方面并不优于对照组（SMD，-0.57 [-1.40至0.26]）。催眠组238例患者中有1例（0.4%）因不良事件（惊恐发作）退出研究。
这项荟萃分析表明，催眠疗法安全有效，能为54%对传统疗法难治的肠易激综合征患者提供长期的症状充分缓解。
