内科疾病中疼痛睡眠障碍的心理治疗

Psychotherapy for pain and sleeping disorder in internal diseases

目的:介绍国内外近20年来在内科疾病中疼痛与睡眠障碍的临床研究概况,以期进一步了解心理治疗的有效性。资料来源:应用计算机检索EBSCOhost数据库1981-09/2005-12的疼痛与睡眠障碍相关的文章,检索词为“sleepingdisor-der”,限定文章语种为English。同时计算机检索1990-01/2005-01的与睡眠障碍相关文章,限定语种为中文,检索词为“睡眠障碍”。资料选择:纳入标准是和疼痛与睡眠障碍相关的内科疾病文章,以实证研究类文献为主,同时包括综述性文章。资料提炼:共收集到相关文献62篇,按上述标准纳入20篇,其余文献均被排除。资料综合:20篇文章中有7篇为中文出版物,对心理治疗和疼痛与睡眠障碍的关系进行了系统阐述。13篇为英文文章,9篇为随机对照研究,4篇为对照研究,其中8个研究对比心理治疗与单纯药物治疗的疗效,5个研究观察了心理治疗结合安慰剂与心理治疗结合药物的治疗作用。结论:睡眠障碍在内科疾病中是十分常见的,尤其是疼痛处于高峰时期,掌握疼痛患者的心理规律、性格特点、情绪表现、配合“安慰剂”及适当药物疗法,使患者从不良心理状态下解脱出来,心理治疗是安全且行之有效的。

ORJETIVE： To introduce the clinical research development on the pain and sleeping disorder with physical disease in China and western countries in recent years, so as to further understand the validity of the psychotherapy. DATA SOURCES： Using the key word of ＂sleeping disorder＂, we searched the EBSCOhost database to identify article,s about pain and sleeping disorder published in the English from September 1981 to December 2005. Meanwhile, we searched the Intemet for Chinese literatures about pain and sleeping disorder from January 1990 to January 2005 with the same key word in Chinese. STUDY SELECTION： We selected the articles about the pain and sleeping disorder with physical disease including clini- cal trials and comprehensive articles. DATA EXTRACTION： Of the 62 articles, only 20 articles were included, the rest were excluded. DATA SYNTHESIS： Among the 20 articles, there were 7 articles published in Chinese, which described the relationship of psychotherapy and pain and sleeping disorder with physical disease; there were 13 English papers, 9 randomized double blind controlled trial, 4 controlled trial. Eight studies compared the therapy with psychotherapy and medicine, 5 studies observed remarkable effects about psychotherapy combining with placebo or medicine. CONCLUSION： Sleeping disorder is universal in physical disease, especially when the patients are in pain. To know the condition, character and feeling of the patients combined with ＂placebo＂ or medicine therapy can recover their health. Psychotherapy on the pain and sleeping disorder with physical disease is safety and effective.