Oregon Health & Science University, Portland, OR.
J Low Genit Tract Dis. 2019 Apr;23(2):170-175. doi: 10.1097/LGT.0000000000000456.
The aim of the study was to compare the effectiveness of mindfulness-based group cognitive behavior therapy (M-gCBT) versus education support group therapy for the pain and distress associated with provoked localized vulvodynia.
Participants were randomized to M-gCBT or education support group therapy. Mindfulness-based group cognitive behavior participants attended 8 weekly sessions. Education support group participants received 8 weeks of online education with 3 in-person group visits. Vaginal insertion pain (tampon test) was the primary outcome. Secondary outcomes (Generalized Anxiety Disorder 7, Beck's Depression Index, Female Sexual Distress Scale, Female Sexual Function Index, and Pain Catastrophizing) were administered before intervention and at the completion of the study period, 3 months, and 6 months. Sample size was based on the ideal number for group dynamics of 6 to 12 participants per group.
Participants were enrolled from August 1, 2016, to January 30, 2017. Thirty-two participants were enrolled and 31 were randomized: 14 to M-gCBT and 17 to education support. Baseline characteristics did not differ significantly. Vaginal insertion pain decreased in both groups but was not statistically different between groups (difference of 1.23; 95% CI = -0.52 to 2.98). At 6 months, participants in the M-gCBT group showed statistically significant improvement in the Female Sexual Function Index, Generalized Anxiety Disorder 7, and Beck's Depression Index compared with the education support group.
Mindfulness-based group cognitive behavior and education support group therapy are effective in reducing pain and distress. However, women in the M-gCBT program showed greater improvement in certain secondary outcomes, indicating that M-gCBT may offer some advantages in reducing distress associated with provoked localized vulvodynia.
本研究旨在比较基于正念的团体认知行为疗法（M-gCBT）与教育支持团体疗法对与诱发性局部外阴痛相关的疼痛和痛苦的疗效。
参与者被随机分配到 M-gCBT 或教育支持团体疗法组。基于正念的团体认知行为组参与者参加了 8 周的课程。教育支持团体组接受了 8 周的在线教育，并进行了 3 次面对面团体访问。阴道插入疼痛（卫生棉条测试）是主要结局。次要结局（广泛性焦虑症 7 项、贝克抑郁指数、女性性困扰量表、女性性功能指数和疼痛灾难化）在干预前和研究期结束时、3 个月和 6 个月进行评估。样本量基于每组 6 至 12 名参与者的理想组动力学数量。
参与者于 2016 年 8 月 1 日至 2017 年 1 月 30 日入组。共纳入 32 名参与者，随机分为 14 名 M-gCBT 组和 17 名教育支持组。基线特征无显著差异。两组阴道插入疼痛均减轻，但组间无统计学差异（差异为 1.23；95%CI=-0.52 至 2.98）。在 6 个月时，与教育支持组相比，M-gCBT 组的女性性功能指数、广泛性焦虑症 7 项和贝克抑郁指数均有统计学显著改善。
基于正念的团体认知行为和教育支持团体疗法均能有效减轻疼痛和痛苦。然而，M-gCBT 组的女性在某些次要结局上表现出更大的改善，表明 M-gCBT 可能在减轻与诱发性局部外阴痛相关的痛苦方面具有一定优势。
