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临床催眠可以减轻慢性疼痛患者的下尿路症状。

Clinical hypnosis can reduce lower urinary tract symptoms in individuals with chronic pain.

机构信息

Department of Psychiatry & Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Department of Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

出版信息

Neurourol Urodyn. 2023 Jan;42(1):330-339. doi: 10.1002/nau.25090. Epub 2022 Nov 15.

Abstract

STUDY PURPOSE

Lower urinary tract symptoms (LUTS) can occur in chronic pain populations at high rates and drastically affect quality of life. Hypnosis is a nonpharmacological treatment used in chronic pain known to have beneficial implications to health outside of pain reduction. This study evaluated the potential for hypnosis to reduce LUTS in a sample of individuals with chronic pain, if baseline LUTS severity affected outcomes, and specific LUTS that may respond to hypnosis.

METHODS

Sixty-four adults with chronic pain and LUTS at a level of detectable symptom change (American Urological Association Symptom Index, AUASI   3) participated in an 8-week group hypnosis protocol. Participants completed validated assessments of LUTS, pain, and overall functioning before, after, 3- and 6-months posttreatment. Linear mixed effects models assessed improvement in LUTS over time while accounting for known factors associated with outcome (e.g., age, gender). The interaction of baseline symptom severity and treatment assessed the potential effect of baseline symptoms on change scores.

RESULTS

Participants experienced significant and meaningful improvements in LUTS following group hypnosis (p = 0.006). There was a significant interaction between baseline symptom severity and treatment (p < 0.001), such that those with severe symptoms experienced the most pronounced gains over time (e.g., an 8.8 point reduction). Gains increased over time for those with moderate and severe symptoms. Changes in LUT symptoms occurred independently of pain relief.

CONCLUSIONS

This pilot study suggests hypnosis has the potential to drastically improve LUTS in individuals with chronic pain, even when pain reduction does not occur. Results provide initial evidence for the treatment potential of hypnosis in urologic pain (and possibly non-pain/benign) populations, with randomized trials needed for definitive outcomes.

摘要

研究目的

下尿路症状(LUTS)在慢性疼痛人群中的发生率较高,会严重影响生活质量。催眠是一种非药物治疗方法,用于慢性疼痛,已知其除了减轻疼痛外,对健康还有有益的影响。本研究评估了催眠在慢性疼痛患者样本中降低 LUTS 的潜力,如果基线 LUTS 严重程度影响结局,以及可能对催眠有反应的特定 LUTS。

方法

64 名慢性疼痛且 LUTS 达到可检测症状变化水平(美国泌尿外科学会症状指数,AUASI 3)的成年人参加了为期 8 周的小组催眠方案。参与者在治疗前、治疗后、3 个月和 6 个月后完成了 LUTS、疼痛和整体功能的验证性评估。线性混合效应模型评估了 LUTS 在时间上的改善,同时考虑了与结局相关的已知因素(例如年龄、性别)。基线症状严重程度与治疗的相互作用评估了基线症状对变化分数的潜在影响。

结果

参与者在接受小组催眠后,LUTS 显著且有意义地改善(p = 0.006)。基线症状严重程度和治疗之间存在显著的相互作用(p < 0.001),即症状严重的患者随时间的推移获得了最明显的改善(例如,减少 8.8 分)。中度和重度症状患者的收益随时间增加。LUTS 症状的变化与疼痛缓解无关。

结论

这项初步研究表明,催眠有可能显著改善慢性疼痛患者的 LUTS,即使疼痛没有减轻。结果为催眠在泌尿科疼痛(可能还有非疼痛/良性)人群中的治疗潜力提供了初步证据,需要进行随机试验以获得明确的结果。

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