Krouwel Matthew, Farley Amanda, Greenfield Sheila, Ismail Tariq, Jolly Kate
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
Complement Ther Med. 2021 Mar;57:102672. doi: 10.1016/j.ctim.2021.102672. Epub 2021 Jan 27.
Hypnotherapy has been shown to be effective at relieving global gastrointestinal symptoms (GGS) in irritable bowel syndrome (IBS). This study examines the impact of hypnotherapy delivery and participant characteristics on IBS outcomes.
This systematic review searched CINAHL, Cochrane Library, Conference Citation Index, Embase, PubMed, PsycARTICLES, PsychINFO, Science Citation index-expanded, Social Science Citation Index. Titles and abstracts, then full-text articles were screened against inclusion criteria: trials with a concurrent comparator of hypnotherapy in adults with IBS diagnosed using Manning or ROME criteria, which provided symptom data. Included studies were extracted and assessed for bias using Cochrane Collaboration 2011 guidance. Random-effects meta-analysis was conducted with sub-group analysis to assess the impact of delivery characteristics on outcomes.
Twelve trials were included, 7 in the meta-analyses. Hypnotherapy reduced the risk of GGS, but this was not statistically significant, (standardised mean difference (SMD) 0.24, [-0.06, 0.54], I 66 %). Higher frequency of sessions (≥1/week) reduced GGS (SMD 0.45 [0.23,0.67] I 0 %), as did higher volumes of intervention (≥8 sessions with ≥6 h of contact) (SMD 0.51 [0.27,0.76] I 0 %) and group interventions (SMD 0.45 [0.03, 0.88] I 62 %). Only volume of intervention produced a significant effect between the subgroups.
This review suggests that high volume hypnotherapy is more beneficial than low and should be adopted for GDH. Both high frequency and group interventions are effective in reducing GGS in IBS. However, the sample size is small and more studies are needed to confirm this.
催眠疗法已被证明对缓解肠易激综合征（IBS）的整体胃肠道症状（GGS）有效。本研究探讨了催眠疗法的实施方式和参与者特征对IBS治疗效果的影响。
本系统评价检索了护理学与健康领域数据库（CINAHL）、考克兰图书馆、会议引文索引、荷兰医学文摘数据库（Embase）、医学期刊数据库（PubMed）、心理学文摘数据库（PsycARTICLES）、心理学文摘数据库（PsychINFO）、科学引文索引扩展版、社会科学引文索引。先筛选标题和摘要，然后根据纳入标准筛选全文：采用曼宁或罗马标准诊断为IBS的成年患者中，将催眠疗法作为同期对照的试验，并提供症状数据。提取纳入研究并根据考克兰协作组织2011年指南评估偏倚情况进行。采用随机效应荟萃分析及亚组分析，以评估实施特征对治疗效果的影响。
纳入12项试验，7项纳入荟萃分析。催眠疗法降低了GGS风险，但无统计学意义（标准化均数差（SMD）0.24，[-0.06, 0.54]，I² 66%）。更高的治疗频率（≥每周1次）降低了GGS（SMD 0.45 [0.23,0.67]，I² 0%），更多的干预量（≥8次治疗且接触时间≥6小时）（SMD 0.51 [0.27,0.76]，I² 0%）以及团体干预（SMD 0.45 [0.03, 0.88]，I² 62%）也有同样效果。仅干预量在亚组间产生了显著效果。
本综述表明，大量催眠疗法比少量更有益，应采用大量催眠疗法治疗GDH。高频和团体干预均能有效降低IBS患者的GGS。然而，样本量较小，需要更多研究来证实这一点。
