Faculty of Education and Health, University of Greenwich, London, SE9 2UG, UK.
Department of Psychology, Goldsmiths, University of London, London, UK.
Neurosci Biobehav Rev. 2019 Apr;99:298-310. doi: 10.1016/j.neubiorev.2019.02.013. Epub 2019 Feb 18.
The current meta-analysis aimed to quantify the effectiveness of hypnosis for reducing pain and identify factors that influence efficacy. Six major databases were systematically searched for trials comparing hypnotic inductions with no-intervention control conditions on pain ratings, threshold and tolerance using experimentally-evoked pain models in healthy participants. Eighty-five eligible studies (primarily crossover trials) were identified, consisting of 3632 participants (hypnosis nö=ö2892, control nö=ö2646). Random effects meta-analysis found analgesic effects of hypnosis for all pain outcomes (gö=ö0.54-0.76, p's<.001). Efficacy was strongly influenced by hypnotic suggestibility and use of direct analgesic suggestion. Specifically, optimal pain relief was obtained for hypnosis with direct analgesic suggestion administered to high and medium suggestibles, who respectively demonstrated 42% (pö<ö.001) and 29% (pö<ö.001) clinically meaningful reductions in pain. Minimal benefits were found for low suggestibles. These findings suggest that hypnotic intervention can deliver meaningful pain relief for most people and therefore may be an effective and safe alternative to pharmaceutical intervention. High quality clinical data is, however, needed to establish generalisability in chronic pain populations.
本次荟萃分析旨在量化催眠对减轻疼痛的有效性，并确定影响疗效的因素。系统地检索了六个主要数据库，以寻找比较在健康参与者中使用实验性诱发疼痛模型的催眠诱导与无干预对照条件下的疼痛评分、阈值和耐受性的试验。确定了 85 项符合条件的研究（主要是交叉试验），包括 3632 名参与者（催眠组 nö=ö2892，对照组 nö=ö2646）。随机效应荟萃分析发现催眠对所有疼痛结局均有镇痛作用（gö=ö0.54-0.76，p<.001）。催眠的暗示性和直接镇痛暗示的使用强烈影响疗效。具体而言，对高和中暗示者给予直接镇痛暗示的催眠可获得最佳的疼痛缓解效果，他们分别显示出 42%（pö<ö.001）和 29%（pö<ö.001）的疼痛有临床意义的减轻。对低暗示者则发现最小的益处。这些发现表明，催眠干预可以为大多数人提供有意义的疼痛缓解，因此可能是一种有效的、安全的药物干预替代方法。然而，需要高质量的临床数据来确定在慢性疼痛人群中的普遍性。
