催眠治疗肌肉骨骼和神经性慢性疼痛:系统评价和荟萃分析。
Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis.
机构信息
PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France.
Laboratoire HAVAE, EA6310, Université de Limoges, Limoges, France.
出版信息
Neurosci Biobehav Rev. 2022 Apr;135:104591. doi: 10.1016/j.neubiorev.2022.104591. Epub 2022 Feb 19.
This systematic review and meta-analysis aims to identify and quantify the current available evidence of hypnosis efficacy to manage pain in patients with chronic musculoskeletal and neuropathic pain. Randomized Control Trials (RCTs) with hypnosis and/or self-hypnosis treatment used to manage musculoskeletal and/or neuropathic chronic pain in adults and assessing pain intensity were included. Reviews, meta-analyses, non-randomized clinical trials, case reports and meeting abstracts were excluded. Five databases, up until May 13th 2021, were used to search for RCTs using hypnosis to manage chronic musculoskeletal and/or neuropathic pain. The protocol is registered on PROSPERO register (CRD42020180298) and no specific funding was received for this review. The risk of bias asessement was conducted according to the revised Cochrane risk of bias tool for randomized control trials (RoB 2.0). Nine eligible RCTs including a total of 530 participants were considered. The main analyses showed a moderate decrease in pain intensity (Hedge's g: -0.42; p = 0.025 after intervention, Hedge's g: -0.37; p = 0.027 after short-term follow-up) and pain interference (Hedge's g: -0.39; p = 0.029) following hypnosis compared to control interventions. A significant moderate to large effect size of hypnosis compared to controls was found for at 8 sessions or more (Hedge's g: -0.555; p = 0.034), compared to a small and not statistically significant effect for fewer than 8 sessions (Hedge's g: -0.299; p = 0.19). These findings suggest that a hypnosis treatment lasting a minimum of 8 sessions could offer an effective complementary approach to manage chronic musculoskeletal and neuropathic pain. Future research is needed to delineate the relevance of hypnosis in practice and its most efficient prescription.
本系统评价和荟萃分析旨在确定和量化当前关于催眠治疗慢性肌肉骨骼和神经病理性疼痛的有效性的证据。纳入了使用催眠和/或自我催眠治疗慢性肌肉骨骼和/或神经病理性疼痛的成人,并评估疼痛强度的随机对照试验(RCT)。排除了综述、荟萃分析、非随机临床试验、病例报告和会议摘要。使用 5 个数据库,截至 2021 年 5 月 13 日,检索使用催眠治疗慢性肌肉骨骼和/或神经病理性疼痛的 RCT。该方案已在 PROSPERO 登记处(CRD42020180298)注册,本综述未收到特定的资助。使用修订后的 Cochrane 随机对照试验偏倚风险评估工具(RoB 2.0)进行偏倚评估。纳入了 9 项符合条件的 RCT,共 530 名参与者。主要分析显示,与对照组相比,催眠干预后疼痛强度(Hedge's g:-0.42;p=0.025)和疼痛干扰(Hedge's g:-0.37;p=0.027)有中度下降。与对照组相比,催眠在 8 次或更多次治疗时具有显著的中到大效应量(Hedge's g:-0.555;p=0.034),而少于 8 次治疗时则为小而无统计学意义的效应量(Hedge's g:-0.299;p=0.19)。这些发现表明,至少持续 8 次的催眠治疗可能是治疗慢性肌肉骨骼和神经病理性疼痛的有效补充方法。需要进一步的研究来阐明催眠在实践中的相关性及其最有效的处方。