Division of Pediatric Gastroenterology, Vanderbilt University Medical Center.
Division of Pediatric Gastroenterology, Louisiana State University.
J Pediatr Gastroenterol Nutr. 2021 Mar 1;72(3):e63-e70. doi: 10.1097/MPG.0000000000002980.
The aim of this study was to implement clinical hypnosis (CH) as an adjunctive therapy for adolescents with Crohn's disease (CD) and to assess the impact of CH on quality of life (QoL), abdominal pain, psychosocial measures, and disease activity compared with standard care.
Forty adolescents with CD were randomized to a hypnosis intervention (HI) or waitlist control (WC) group. The intervention consisted of 1 in-person CH session, self-hypnosis education, and recordings for home practice. Data was collected at baseline, after the 8-week intervention, and at week 16. The primary outcome was patient- and parent-reported QoL; secondary outcomes were patient-reported abdominal pain, depression, anxiety, and sleep; school absences; and disease activity by Pediatric Crohn's Disease Activity Index. Paired and independent t-tests were used to compare differences from baseline to postintervention within and between groups.
Forty patients (50% girls, mean 15.8 years) were enrolled from February to May 2019. Seventy-eight percent had inactive disease, and 55% had abdominal pain. Post intervention, significant improvements were noted in HI parent-reported QoL compared with WC in total score (P = 0.05), social functioning (P = 0.01), and school functioning (P = 0.04) but patient-reported QoL was unchanged. Abdominal pain severity significantly improved in HI compared with WC (P = 0.03). School absences decreased in significantly more intervention than control patients (P = 0.01). Patients who practiced self-hypnosis consistently showed a trend toward greater QoL improvement than those who did not (P = 0.1).
CH is an acceptable and feasible adjunct in CD and may improve psychosocial QoL and abdominal pain. Further research is warranted.
本研究旨在将临床催眠(CH)作为克罗恩病(CD)青少年的辅助治疗方法,并评估 CH 对生活质量(QoL)、腹痛、心理社会指标以及与标准护理相比的疾病活动的影响。
40 名 CD 青少年被随机分配到催眠干预(HI)或候补对照(WC)组。干预包括 1 次面对面 CH 治疗、自我催眠教育和家庭练习录音。数据在基线、8 周干预后和第 16 周收集。主要结果是患者和家长报告的 QoL;次要结果是患者报告的腹痛、抑郁、焦虑和睡眠、缺课和儿童克罗恩病活动指数评估的疾病活动。采用配对和独立 t 检验比较组内和组间从基线到干预后的差异。
2019 年 2 月至 5 月期间共招募了 40 名患者(50%为女性,平均年龄为 15.8 岁)。78%的患者疾病处于不活跃状态,55%的患者有腹痛。干预后,与 WC 相比,HI 家长报告的 QoL 总分(P=0.05)、社会功能(P=0.01)和学校功能(P=0.04)显著改善,但患者报告的 QoL 无变化。与 WC 相比,HI 组腹痛严重程度显著改善(P=0.03)。与对照组相比,接受干预的患者缺课明显减少(P=0.01)。与未进行自我催眠的患者相比,持续进行自我催眠的患者 QoL 改善趋势更为明显(P=0.1)。
CH 是 CD 的一种可接受且可行的辅助治疗方法,可能改善心理社会 QoL 和腹痛。需要进一步研究。