Keefe F J, Caldwell D S
Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Med Clin North Am. 1997 Jan;81(1):277-90. doi: 10.1016/s0025-7125(05)70515-0.
Cognitive-behavioral approaches appear to offer a viable alternative for the management of arthritis pain. Controlled studies have documented the efficacy of CBT protocols for managing pain in individuals having OA and RA. Preliminary studies examining the efficacy of CBT for FM patients have also yielded encouraging results. A number of clinical and research issues need attention if CBT is to be incorporated into rheumatology practice settings. These issues include identifying the most important components of CBT, developing strategies for matching CBT interventions to patients' readiness for behavior change, testing the efficacy of different therapy formats (e.g., individual versus group), broadening the scope of CBT to address issues other than pain, and insurance reimbursement.
认知行为疗法似乎为关节炎疼痛的管理提供了一种可行的替代方法。对照研究已证明认知行为疗法方案在管理骨关节炎(OA)和类风湿关节炎(RA)患者疼痛方面的有效性。对纤维肌痛(FM)患者进行的认知行为疗法疗效的初步研究也取得了令人鼓舞的结果。如果要将认知行为疗法纳入风湿病学实践环境,一些临床和研究问题需要关注。这些问题包括确定认知行为疗法的最重要组成部分、制定使认知行为疗法干预措施与患者行为改变准备程度相匹配的策略、测试不同治疗形式(如个体治疗与团体治疗)的疗效、扩大认知行为疗法的范围以解决疼痛以外的问题以及保险报销。