Tan G, Rintala D H, Jensen M P, Fukui T, Smith D, Williams W
Department of Psychology, National University of Singapore, Singapore.
Eur J Pain. 2015 Feb;19(2):271-80. doi: 10.1002/ejp.545. Epub 2014 Jun 17.
Chronic low back pain (CLBP) is common and results in significant costs to individuals, families and society. Although some research supports the efficacy of hypnosis for CLBP, we know little about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of treatment benefits beyond 3 months.
One hundred veterans with CLBP participated in a randomized, four-group design study. The groups were (1) an eight-session self-hypnosis training intervention without audio recordings for home practice; (2) an eight-session self-hypnosis training intervention with recordings; (3) a two-session self-hypnosis training intervention with recordings and brief weekly reminder telephone calls; and (4) an eight-session active (biofeedback) control intervention.
Participants in all four groups reported significant pre- to post-treatment improvements in pain intensity, pain interference and sleep quality. The hypnosis groups combined reported significantly more pain intensity reduction than the control group. There was no significant difference among the three hypnosis conditions. Over half of the participants who received hypnosis reported clinically meaningful (≥ 30%) reductions in pain intensity, and they maintained these benefits for at least 6 months after treatment. Neither hypnotizability nor amount of home practice was associated significantly with treatment outcome.
The findings indicate that two sessions of self-hypnosis training with audio recordings for home practice may be as effective as eight sessions of hypnosis treatment. If replicated in other patient samples, the findings have important implications for the application of hypnosis treatment for chronic pain management.
慢性下腰痛（CLBP）很常见，给个人、家庭和社会带来了巨大的成本。尽管一些研究支持催眠对CLBP的疗效，但我们对产生显著益处所需的最小剂量、家庭练习和催眠易感性对结果的作用，或治疗益处超过3个月后的维持情况知之甚少。
100名患有CLBP的退伍军人参与了一项随机四组设计研究。这些组分别为：（1）一个为期八节的自我催眠训练干预组，没有用于家庭练习的录音；（2）一个为期八节的自我催眠训练干预组，有录音；（3）一个为期两节的自我催眠训练干预组，有录音且每周有简短的提醒电话；（4）一个为期八节的主动（生物反馈）对照组。
所有四组参与者在治疗前到治疗后均报告疼痛强度、疼痛干扰和睡眠质量有显著改善。合并后的催眠组报告的疼痛强度降低显著多于对照组。三种催眠条件之间没有显著差异。超过一半接受催眠的参与者报告疼痛强度有临床意义（≥30%）的降低，并且在治疗后至少6个月内维持了这些益处。催眠易感性和家庭练习量均与治疗结果无显著关联。
研究结果表明，两节带有家庭练习录音的自我催眠训练可能与八节催眠治疗一样有效。如果在其他患者样本中得到重复验证，这些发现对催眠治疗在慢性疼痛管理中的应用具有重要意义。
