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镜像疗法:一种用于疼痛管理的潜在干预措施。

Mirror therapy: A potential intervention for pain management.

作者信息

Wittkopf Priscilla G, Johnson Mark I

机构信息

MSc. Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University and Leeds Pallium Research Group, Leeds, United Kingdom.

PhD. Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University and Leeds Pallium Research Group, Leeds, United Kingdom.

出版信息

Rev Assoc Med Bras (1992). 2017 Nov;63(11):1000-1005. doi: 10.1590/1806-9282.63.11.1000.

Abstract

The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery. The physiological rationale of mirror therapy for the management of pain and the evidence of clinical efficacy based on recent systematic reviews are also discussed. Mirror therapy, whereby a mirror is placed in a position so that the patient can view a reflection of a body part, has been used to treat phantom limb pain, complex regional pain syndrome, neuropathy and low back pain. Research evidence suggests that a course of treatment (four weeks) of mirror therapy may reduce chronic pain. Contraindications and side effects are few. The mechanism of action of mirror therapy remains uncertain, with reintegration of motor and sensory systems, restored body image and control over fear-avoidance likely to influence outcome. The evidence for clinical efficacy of mirror therapy is encouraging, but not yet definitive. Nevertheless, mirror therapy is inexpensive, safe and easy for the patient to self-administer.

摘要

慢性疼痛及其相关残疾对患者和医疗保健系统的影响是众所周知的。药物治疗通常是慢性疼痛的首选治疗方法,尽管副作用和高昂的成本限制了其长期使用。推荐使用廉价、安全且易于自我实施的非药物疗法,如镜像疗法,作为疼痛治疗的辅助手段。本综述的目的是描述镜像疗法的使用原则,以便将其纳入医疗保健服务中。还讨论了镜像疗法治疗疼痛的生理原理以及基于近期系统评价的临床疗效证据。镜像疗法是将镜子放置在一个位置,使患者能够看到身体某个部位的反射影像,已被用于治疗幻肢痛、复杂性区域疼痛综合征、神经病变和腰痛。研究证据表明,为期四周的镜像疗法疗程可能会减轻慢性疼痛。其禁忌症和副作用较少。镜像疗法的作用机制仍不确定,运动和感觉系统的重新整合、恢复身体形象以及对恐惧回避的控制可能会影响治疗效果。镜像疗法临床疗效的证据令人鼓舞,但尚未定论。尽管如此,镜像疗法价格低廉、安全且患者易于自我实施。

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