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基于正念减压疗法(MBSR)治疗慢性背痛——一项评估丘脑皮质节律紊乱的观察性研究

Mindfulness-based Stress Reduction (MBSR) as Treatment for Chronic Back Pain - an Observational Study with Assessment of Thalamocortical Dysrhythmia.

作者信息

Schmidt Stefan, Gmeiner Sophia, Schultz Claudia, Löwer Marc, Kuhn Klaus, Naranjo José Raúl, Brenneisen Christina, Hinterberger Thilo

机构信息

Department of Psychosomatic Medicine, Medical Center - University of Freiburg, Freiburg, Germany.

出版信息

Forsch Komplementmed. 2015;22(5):298-303. doi: 10.1159/000440687. Epub 2015 Oct 16.

Abstract

BACKGROUND

A pilot study of an 8-week mindfulness-based stress reduction (MBSR) program on a sample of low back pain patients was conducted in order to assess the feasibility and effectiveness of the intervention as well as changes in an EEG pattern called thalamocortical dysrhythmia which is associated with chronic pain.

PATIENTS AND METHODS

22 patients with chronic low back pain participated in an MBSR program. Effect sizes were measured for psychological functioning, pain severity, and quality of life. Furthermore, 4 parameters of the EEG power spectral density were assessed.

RESULTS

Medium size effect sizes were found for health-related quality of life (EQ-5D, VAS, d = 0.43, p = 0.02; SF-12, psychological functioning, d = 0.50, p = 0.05), health-related life satisfaction (questions on life satisfaction d = 0.69, p = 0.01), depression (HADS, d = 0.48, p = 0.04, Brief Symptom Inventory d = 0.41, p = 0.04), and affective pain perception (pain perception scale d = 0.50, p = 0.04). The most relevant pain severity measurements improved in the range of d = 0.45-0.75 (p = 0.01-0.24). EEG analyses revealed no differences between the pre- and post-intervention.

CONCLUSION

MBSR is a feasible intervention for patients with low back pain. They benefit from medium size effects which are comparable to similar behavioral interventions. Randomized controlled trials are needed in order to determine the specificity of these benefits.

摘要

背景

开展了一项针对腰痛患者样本的为期8周的基于正念减压疗法(MBSR)的初步研究,以评估该干预措施的可行性和有效性,以及一种称为丘脑皮质节律失调的脑电图模式的变化,这种变化与慢性疼痛相关。

患者与方法

22名慢性腰痛患者参与了MBSR项目。对心理功能、疼痛严重程度和生活质量进行了效应量测量。此外,还评估了脑电图功率谱密度的4个参数。

结果

在健康相关生活质量(EQ-5D、视觉模拟评分,d = 0.43,p = 0.02;SF-12,心理功能,d = 0.50,p = 0.05)、健康相关生活满意度(生活满意度问题,d = 0.69,p = 0.01)、抑郁(医院焦虑抑郁量表,d = 0.48,p = 0.04;简明症状量表,d = 0.41,p = 0.04)和情感性疼痛感知(疼痛感知量表,d = 0.50,p = 0.04)方面发现了中等效应量。最相关的疼痛严重程度测量指标在d = 0.45 - 0.75范围内有所改善(p = 0.01 - 0.24)。脑电图分析显示干预前后无差异。

结论

MBSR对腰痛患者是一种可行的干预措施。他们从中等效应量中获益,这与类似的行为干预相当。需要进行随机对照试验以确定这些益处的特异性。

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