Häuser Winfried, Hagl Maria, Schmierer Albrecht, Hansen Ernil
Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken and Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Münich, Department of Psychology, Ludwig-Maximilians-Universität München, Münich, Dental Practice Schmierer & Kratzenstein, Stuttgart, Department of Anesthesiology, Universitätsklinikum Regensburg.
Dtsch Arztebl Int. 2016 Apr 29;113(17):289-96. doi: 10.3238/arztebl.2016.0289.
The efficacy and safety of hypnotic techniques in somatic medicine, known as medical hypnosis, have not been supported to date by adequate scientific evidence.
We systematically reviewed meta-analyses of randomized controlled trials (RCTs) of medical hypnosis. Relevant publications (January 2005 to June 2015) were sought in the Cochrane databases CDSR and DARE, and in PubMed. Meta-analyses involving at least 400 patients were included in the present analysis. Their methodological quality was assessed with AMSTAR (A Measurement Tool to Assess Systematic Reviews). An additional search was carried out in the CENTRAL and PubMed databases for RCTs of waking suggestion (therapeutic suggestion without formal trance induction) in somatic medicine.
Out of the 391 publications retrieved, five were reports of metaanalyses that met our inclusion criteria. One of these meta-analyses was of high methodological quality; three were of moderate quality, and one was of poor quality. Hypnosis was superior to controls with respect to the reduction of pain and emotional stress during medical interventions (34 RCTs, 2597 patients) as well as the reduction of irritable bowel symptoms (8 RCTs, 464 patients). Two meta-analyses revealed no differences between hypnosis and control treatment with respect to the side effects and safety of treatment. The effect size of hypnosis on emotional stress during medical interventions was low in one meta-analysis, moderate in one, and high in one. The effect size on pain during medical interventions was low. Five RCTs indicated that waking suggestion is effective in medical procedures.
Medical hypnosis is a safe and effective complementary technique for use in medical procedures and in the treatment of irritable bowel syndrome. Waking suggestions can be a component of effective doctor-patient communication in routine clinical situations.
催眠技术在躯体医学中的疗效和安全性,即所谓的医学催眠,迄今为止尚未得到充分的科学证据支持。
我们系统回顾了医学催眠随机对照试验(RCT)的荟萃分析。在Cochrane数据库CDSR和DARE以及PubMed中检索了相关出版物(2005年1月至2015年6月)。本分析纳入了至少涉及400名患者的荟萃分析。使用AMSTAR(一种评估系统评价的测量工具)评估其方法学质量。还在CENTRAL和PubMed数据库中对躯体医学中清醒暗示(无正式催眠诱导的治疗性暗示)的RCT进行了额外检索。
在检索到的391篇出版物中,有5篇是符合我们纳入标准的荟萃分析报告。其中一项荟萃分析方法学质量高;三项质量中等,一项质量差。在医疗干预期间减轻疼痛和情绪压力方面(34项RCT,2597名患者)以及减轻肠易激综合征症状方面(8项RCT,464名患者),催眠优于对照组。两项荟萃分析显示,催眠与对照治疗在治疗副作用和安全性方面没有差异。在一项荟萃分析中,催眠对医疗干预期间情绪压力的效应量低,一项为中等,一项为高。对医疗干预期间疼痛的效应量低。五项RCT表明清醒暗示在医疗程序中有效。
医学催眠是一种用于医疗程序和治疗肠易激综合征的安全有效的辅助技术。清醒暗示可以成为常规临床情况下有效医患沟通的一部分。