Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain.
Biohealth Research Institute in Granada (ibs. GRANADA), E-18012 Granada, Spain.
Medicina (Kaunas). 2024 Oct 13;60(10):1677. doi: 10.3390/medicina60101677.
: To evaluate the effectiveness of an integral HAMMAM experience, a 4-week therapeutic program that combined hydrotherapy and Swedish massage, applied in a multisensorial immersive environment, on pain, well-being and quality of life (QoL) in women with endometriosis-related chronic pelvic pain that is unresponsive to conventional treatment. : This randomized controlled trial included 44 women with endometriosis. They were randomly allocated to either the 'HAMMAM' group ( = 21) or to a control group ( = 23). The primary outcome, pain intensity, was evaluated using numeric rating scales (NRSs). The secondary outcomes were pain interference, pain-related catastrophic thoughts, pressure pain thresholds (PPTs), subjective well-being, functional capacity and QoL, which were evaluated using the brief pain inventory (BPI), the pain catastrophizing scale (PCS), algometry, the subjective well-being scale-20 (EBS-20), the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) and the Endometriosis Health Profile-30 Questionnaire (EHP-30), respectively. The primary and secondary outcomes were measured at the baseline and after the intervention. The statistical (between-group analyses of covariance) and clinical effects were analyzed by the intention to treat. : The adherence rate was 100.0% and the mean (± standard deviation) satisfaction was 9.71 ± 0.46 out of 10. No remarkable health problems were reported during the trial. The 'HAMMAM' intervention improved dysmenorrhea and dyspareunia after the intervention with large and moderate effect sizes, respectively. Improvements in pain interference during sleep and PPTs in the pelvic region were also observed in women allocated to the 'HAMMAM' group. No effects were observed in catastrophizing thoughts, well-being nor QoL, except for the sleep subscale. : A 4-week program of an integral 'HAMMAM' experience combining hydrotherapy and massage in a multisensorial immersive environment is a feasible and effective intervention to alleviate pain during menstruation and sexual intercourse as well as pain interference with sleep in women with endometriosis.
为评估综合水疗和瑞典按摩的 HAMMAM 体验疗法在常规治疗无效的慢性骨盆疼痛的子宫内膜异位症女性中的有效性，我们开展了一项为期 4 周的治疗方案，将水疗和瑞典按摩相结合，并应用于多感官沉浸式环境。该方案对疼痛、幸福感和生活质量（QoL）的影响。这是一项随机对照试验，纳入了 44 名子宫内膜异位症相关慢性盆腔疼痛的女性。她们被随机分配到 HAMMAM 组（n=21）或对照组（n=23）。主要结局指标为疼痛强度，采用数字评分量表（NRS）进行评估。次要结局指标包括疼痛干扰、疼痛相关灾难性思维、压力疼痛阈值（PPT）、主观幸福感、功能能力和 QoL，分别采用简明疼痛量表（BPI）、疼痛灾难化量表（PCS）、压力计、主观幸福感量表-20（EBS-20）、患者报告结局测量信息系统-29 （PROMIS-29）和子宫内膜异位症健康状况问卷-30（EHP-30）进行评估。主要和次要结局在基线和干预后进行测量。采用意向治疗进行统计学（组间协方差分析）和临床效果分析。
依从率为 100.0%，平均（±标准差）满意度为 10 分中的 9.71±0.46 分。试验过程中未报告严重健康问题。HAMMAM 干预分别显著改善了痛经和性交痛，其效应量大小分别为大、中。HAMMAM 组女性的睡眠期间疼痛干扰和骨盆区域 PPT 也得到改善。除睡眠亚分外，灾难性思维、幸福感和 QoL 均未观察到改善。
为期 4 周的综合 HAMMAM 体验疗法，包括水疗和按摩，以及多感官沉浸式环境，是一种可行且有效的干预措施，可减轻子宫内膜异位症女性月经和性交期间的疼痛，以及睡眠期间的疼痛干扰。
