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基于正念的慢性疼痛管理中的催产素调节

Oxytocin Modulation in Mindfulness-Based Pain Management for Chronic Pain.

作者信息

Aygün Oytun, Mohr Emily, Duff Colin, Matthew Sophie, Schoenberg Poppy

机构信息

Laboratoire DysCo, Université Paris 8 Vincennes-Saint-Denis, 93526 Saint-Denis, France.

Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA.

出版信息

Life (Basel). 2024 Feb 15;14(2):253. doi: 10.3390/life14020253.

Abstract

In the context of chronic pain management, opioid-based treatments have been heavily relied upon, raising concerns related to addiction and misuse. Non-pharmacological approaches, such as Mindfulness-Based Pain Management, offer alternative strategies. We conducted a mechanistic clinical study to investigate the impact of an 8-week Mindfulness-Based Pain Management intervention on chronic pain, the modulation of inflammatory markers, stress physiology, and oxytocin, and their interplay with clinical pain symptoms and perception, in comparison to a patient wait-list active control. A total of 65 participants, including 50 chronic pain patients and 15 healthy controls, underwent salivary assays to assess endocrine markers, oxytocin, interleukin (IL)-1b, IL-6, IL-8, tumor necrosis factor (TNF)-a, and dehydroepiandrosterone sulphate (DHEA-S). Psychological assessments were also conducted to evaluate aspects of pain perception, mindfulness, mood, and well-being. Findings revealed significant differences between chronic pain patients and healthy controls in various clinical metrics, highlighting the psychological distress experienced by patients. Following Mindfulness-Based Pain Management, oxytocin levels significantly increased in chronic pain patients, that was not observed in the patient wait-list control group. In contrast, cytokine and DHEA-S levels decreased (not to statistically significant margins) supporting anti-inflammatory effects of Mindfulness-Based Pain Management. The fact DHEA-S levels, a marker of stress, did attenuate but not to statistically meaningful levels, suggests that pain reduction was not solely related to stress reduction, and that oxytocin pathways may be more salient than previously considered. Psychological assessments demonstrated substantial improvements in pain perception and mood in the intervention group. These results contribute to the growing body of evidence regarding the effectiveness of mindfulness-based interventions in chronic pain management and underscore oxytocin's potential role as a therapeutic target.

摘要

在慢性疼痛管理的背景下,基于阿片类药物的治疗方法一直被大量依赖,这引发了对成瘾和滥用的担忧。非药物方法,如基于正念的疼痛管理,提供了替代策略。我们进行了一项机制性临床研究,以调查与患者等待名单主动对照组相比,为期8周的基于正念的疼痛管理干预对慢性疼痛、炎症标志物调节、应激生理学和催产素的影响,以及它们与临床疼痛症状和感知的相互作用。共有65名参与者,包括50名慢性疼痛患者和15名健康对照者,接受了唾液检测以评估内分泌标志物、催产素、白细胞介素(IL)-1β、IL-6、IL-8、肿瘤坏死因子(TNF)-α和硫酸脱氢表雄酮(DHEA-S)。还进行了心理评估,以评估疼痛感知、正念、情绪和幸福感等方面。研究结果显示,慢性疼痛患者和健康对照者在各种临床指标上存在显著差异,突出了患者所经历的心理困扰。在基于正念的疼痛管理之后,慢性疼痛患者的催产素水平显著升高,而在患者等待名单对照组中未观察到这种情况。相比之下,细胞因子和DHEA-S水平下降(未达到统计学显著水平),支持基于正念的疼痛管理的抗炎作用。应激标志物DHEA-S水平确实有所下降,但未达到统计学有意义的水平,这表明疼痛减轻并非仅仅与应激减轻有关,并且催产素途径可能比之前认为的更为突出。心理评估表明,干预组的疼痛感知和情绪有了显著改善。这些结果为越来越多关于基于正念的干预在慢性疼痛管理中的有效性的证据做出了贡献,并强调了催产素作为治疗靶点的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0de4/10890287/ba3d05d554f3/life-14-00253-g001.jpg

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