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运动和心理治疗对慢性疼痛患者心理社会结局的影响。

The impact of exercise and psychotherapy on psychosocial outcomes for patients with chronic pain.

作者信息

Nakamura Mizuyuki, Hattammaru Yoshiyasu, Oiwa Ayano, Hamaguchi Takayuki, Tairako Yukino, Kurata Jiro

机构信息

Department of Anesthesiology, Division of Pain Clinic, The Jikei University School of Medicine, Nishi-Shimbashi 3-25-8, Minato-ku, Tokyo, Japan.

Abiko Pain Clinic, Abiko, Chiba, Japan.

出版信息

J Anesth. 2025 Jun 8. doi: 10.1007/s00540-025-03523-9.

Abstract

PURPOSE

This study aimed to quantitatively evaluate the characteristics of patients with chronic pain and differences in their responses to different treatment approaches.

METHODS

A retrospective review was performed regarding patients with chronic pain who visited an interdisciplinary pain treatment centre between January 1, 2018, and March 31, 2023. The patients were categorised into four groups based on the treatment received: a conventional therapy group treated by medical doctors, an exercise therapy group received additional exercise therapy, a psychotherapy group received additional psychotherapy, and an interdisciplinary treatment group received additional exercise therapy and psychotherapy. Responses to pain-related and psychosocial questionnaire results were compared between baseline and six months post-treatment.

RESULTS

Of the 1,967 initial participants, 239 patients met the eligibility criteria and their data were included in the analysis. In the Conventional therapy group, the indicators showed improvement in pain symptoms, excluding the Pain Self-Efficacy Questionnaire (PSEQ) and Hospital Anxiety and Depression Scale-Depression (HADS-D) scores. In the Exercise therapy group, significant improvements in PSEQ (from 28.15 to 33.34, p < 0.001) and HADS-D (from 7.17 to 6.35, p = 0.035) scores were documented. HADS-Anxiety scores decreased in the Psychotherapy group from 10.36 to 7.91 (p = 0.028). The Interdisciplinary treatment group showed a significant reduction in pain catastrophizing scale scores (from 35.15 to 26.31, p = 0.038).

CONCLUSIONS

This study indicated that exercise therapy, psychotherapy, and interdisciplinary approaches might contribute to improvements in psychosocial outcomes amongst patients with chronic pain. Although the effects of exercise therapy were more consistent, psychotherapy and interdisciplinary treatment demonstrated potential benefits.

摘要

目的

本研究旨在定量评估慢性疼痛患者的特征以及他们对不同治疗方法反应的差异。

方法

对2018年1月1日至2023年3月31日期间前往跨学科疼痛治疗中心就诊的慢性疼痛患者进行回顾性研究。根据接受的治疗将患者分为四组:由医生进行常规治疗的常规治疗组、接受额外运动疗法的运动治疗组、接受额外心理治疗的心理治疗组以及接受额外运动疗法和心理治疗的跨学科治疗组。比较治疗前基线和治疗后六个月疼痛相关及心理社会问卷结果的反应。

结果

在1967名初始参与者中,239名患者符合纳入标准,其数据纳入分析。在常规治疗组中,各项指标显示疼痛症状有所改善,但疼痛自我效能问卷(PSEQ)和医院焦虑抑郁量表-抑郁(HADS-D)得分除外。在运动治疗组中,记录到PSEQ得分(从28.15提高到33.34,p<0.001)和HADS-D得分(从7.17降至6.35,p=0.035)有显著改善。心理治疗组的HADS-焦虑得分从10.36降至7.91(p=0.028)。跨学科治疗组的疼痛灾难化量表得分显著降低(从35.15降至26.31,p=0.038)。

结论

本研究表明运动疗法、心理疗法和跨学科方法可能有助于改善慢性疼痛患者的心理社会结局。虽然运动疗法的效果更一致,但心理疗法和跨学科治疗也显示出潜在益处。

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