正念冥想治疗慢性疼痛：系统评价与荟萃分析
Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.
作者信息
Hilton Lara, Hempel Susanne, Ewing Brett A, Apaydin Eric, Xenakis Lea, Newberry Sydne, Colaiaco Ben, Maher Alicia Ruelaz, Shanman Roberta M, Sorbero Melony E, Maglione Margaret A
机构信息
RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
出版信息
Ann Behav Med. 2017 Apr;51(2):199-213. doi: 10.1007/s12160-016-9844-2.
BACKGROUND
Chronic pain patients increasingly seek treatment through mindfulness meditation.
PURPOSE
This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.
METHOD
We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.
RESULTS
Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.
CONCLUSIONS
While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.
背景
慢性疼痛患者越来越多地通过正念冥想寻求治疗。
目的
本研究旨在综合关于正念冥想干预对成人慢性疼痛治疗的疗效和安全性的证据。
方法
我们对随机对照试验（RCT）进行了系统评价，并使用Hartung-Knapp-Sidik-Jonkman方法对随机效应模型进行荟萃分析。采用GRADE方法评估证据质量。结局包括疼痛、抑郁、生活质量和镇痛药使用情况。
结果
38项RCT符合纳入标准；7项报告了安全性。我们发现低质量证据表明，在30项RCT中，与所有类型的对照相比，正念冥想与疼痛的小幅减轻相关。在抑郁症状和生活质量方面也发现了统计学上的显著效果。
结论
虽然正念冥想可改善疼痛、抑郁症状和生活质量，但仍需要更多设计良好、严谨且大规模的RCT来明确提供正念冥想对慢性疼痛疗效的评估。
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