Ruiz Romero M V, Lobato Parra E, Porrúa Del Saz A, Martínez Monrobé M B, Pereira Delgado C M, Gómez Hernández M B
Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España; Universidad Internacional de Valencia, Valencia, España.
Unidad de Calidad e Investigación, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
J Healthc Qual Res. 2024 May-Jun;39(3):168-187. doi: 10.1016/j.jhqr.2024.02.004. Epub 2024 Mar 30.
Chronic pain is a public health problem suffered by 20% of the world's population. Pharmacological approaches are insufficient, so a multi-therapeutic approach that also includes non-pharmacological therapies (psychological therapies, meditation, physical exercise, healthy habits, etc.) is proposed. The aim of this review was to review the existing scientific evidence on the effect of multicomponent programs with non-pharmacological therapies in people with chronic non-oncologic pain. To this end, a search for scientific articles was carried out in three databases (PubMed, Web of Science and PsycINFO) and 17 articles were selected, following the PRISMA recommendations. The patients who participated in these programs were mostly women, aged 18 to 80years, working or on sick leave due to pain, with secondary education or less and married. The most frequent pain was musculoskeletal, mainly low back pain. All the articles studied the effectiveness of two or more therapies, highlighting psychological therapies, physical exercise and education. Positive results were obtained in the reduction of different variables such as pain, pain catastrophizing, anxiety and depression, in addition to improving functionality and quality of life. It has also been shown that patients' prior expectations regarding the intervention influence its effectiveness. Although throughout the review there was great heterogeneity in the interventions, in the evaluation methods and in the results themselves, it can be concluded that multicomponent programs show positive results in the management of chronic pain, and should therefore be incorporated as a routine therapeutic treatment.
慢性疼痛是一个影响全球20%人口的公共卫生问题。药物治疗方法并不充分,因此有人提出采用多疗法,其中也包括非药物疗法(心理疗法、冥想、体育锻炼、健康习惯等)。本综述的目的是回顾现有关于多成分非药物疗法方案对慢性非肿瘤性疼痛患者疗效的科学证据。为此,按照PRISMA建议,在三个数据库(PubMed、科学网和PsycINFO)中检索科学文章,共筛选出17篇文章。参与这些方案的患者大多为女性,年龄在18至80岁之间,因疼痛而工作或休病假,接受过中等及以下教育且已婚。最常见的疼痛是肌肉骨骼疼痛,主要是腰痛。所有文章都研究了两种或更多疗法的有效性,其中心理疗法、体育锻炼和教育最为突出。除了改善功能和生活质量外,在减轻疼痛、疼痛灾难化、焦虑和抑郁等不同变量方面也取得了积极成果。研究还表明,患者对干预措施的预期会影响其效果。尽管在整个综述中,干预措施、评估方法和结果本身存在很大异质性,但可以得出结论,多成分方案在慢性疼痛管理中显示出积极效果,因此应作为常规治疗方法纳入。
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