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基于正念减压疗法对慢性下腰痛的影响:一项关于对内分泌、身体和心理功能影响的研究

Mindfulness-Based Stress Reduction Program on Chronic Low-Back Pain: A Study Investigating the Impact on Endocrine, Physical, and Psychologic Functioning.

作者信息

Ardito Rita B, Pirro Piero Stanley, Re Tania S, Bonapace Isabella, Menardo Valentino, Bruno Emanuela, Gianotti Laura

机构信息

1 Department of Psychology, University of Torino , Torino, Italy .

2 Center for Cognitive Science, University of Torino , Torino, Italy .

出版信息

J Altern Complement Med. 2017 Aug;23(8):615-623. doi: 10.1089/acm.2016.0423. Epub 2017 May 24.

Abstract

OBJECTIVE

To explore the impact of the Mindfulness-Based Stress Reduction (MBSR) program on pain severity and endocrine, physical, and psychologic functioning in patients with chronic low-back pain (CLBP).

METHODS

A total of 28 participants were enrolled in the study between January and June 2014; 17 participants were sequentially sampled for an 8-week MBSR program, and 11 were placed on a waitlist control group. Pain severity, quality of life (QOL), global psychologic functioning, and depression were assessed at baseline, at the end of treatment, and 4-5 months post-treatment for both groups. Morning and evening salivary cortisol was assessed at multiple time points in participants in the MBSR group.

RESULTS

In comparison with baseline, evening cortisol release showed a significant increase post-treatment. Significant differences between groups were found in pain severity. Medium-to-large effect sizes were found for between-group differences in both pain severity and QOL.

CONCLUSIONS

The cortisol increase in the MBSR group is a promising finding, in the context of CLBP hypocortisolism. Data show that the effects of the MBSR treatment may take time to surface. However, due to small sample size, decisive interpretation of findings is limited. Nevertheless, the MBSR program may show promise for CLBP and should be an avenue for further investigation through larger clinical trials within healthcare systems.

摘要

目的

探讨基于正念减压疗法(MBSR)对慢性下腰痛(CLBP)患者疼痛严重程度及内分泌、身体和心理功能的影响。

方法

2014年1月至6月共有28名参与者纳入研究;17名参与者依次接受为期8周的MBSR项目,11名被纳入等待名单对照组。两组在基线、治疗结束时以及治疗后4至5个月评估疼痛严重程度、生活质量(QOL)、整体心理功能和抑郁情况。对MBSR组参与者在多个时间点评估早晚唾液皮质醇水平。

结果

与基线相比,治疗后晚间皮质醇释放显著增加。两组在疼痛严重程度上存在显著差异。在疼痛严重程度和生活质量的组间差异中发现了中到较大的效应量。

结论

在CLBP患者皮质醇水平低下的背景下,MBSR组皮质醇增加是一个有前景的发现。数据表明MBSR治疗的效果可能需要时间才能显现。然而,由于样本量小,对研究结果的决定性解释有限。尽管如此,MBSR项目可能对CLBP有前景,应成为医疗系统内通过更大规模临床试验进一步研究的一个途径。

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