ABSTRACT

Cognitive behavioral therapy (CBT) is effective for pain relief in children and adolescents with functional abdominal pain disorders (FAPDs). However, few studies have focused on the FAPDs specifically and the medium-term or long-term results of CBT. In this meta-analysis, we investigated the efficacy of CBT in pediatric FAPDs and unclassified chronic or recurrent abdominal pain (CAP and RAP, respectively). We searched the PubMed, Embase, and Cochrane Library databases for related randomized controlled trials until August 2021. Eventually, 10 trials with 872 participants were included. The methodological quality of the studies was assessed, and data on two primary and four secondary outcomes of interest were extracted. We used the standardized mean difference (SMD) to measure the same outcome, and precisions of effect sizes were reported as 95% confidence intervals (CIs). We found that CBT had significantly positive effects on reducing pain intensity immediately (SMD: −0.54 [CI: −0.9, −0.19], p = 0.003), 3 months after the intervention (SMD: −0.55; [CI: −1.01, −0.1], p = 0.02) and 12 months after the intervention (SMD: −0.32; [CI: −0.56, −0.08], p = 0.008). CBT also reduced the severity of gastrointestinal symptoms, depression, and solicitousness, improved the quality of life and decreased the total social cost. Future studies should consider uniform interventions in the control group and comparing different CBT delivery methods.

摘要

认知行为疗法 (CBT) 可有效缓解患有功能性腹痛疾病 (FAPD) 的儿童和青少年的疼痛。然而，很少有研究专门关注 FAPD 以及 CBT 的中长期结果。在这项荟萃分析中，我们研究了 CBT 对儿科 FAPD 和未分类的慢性或复发性腹痛（分别为 CAP 和 RAP）的疗效。我们在 PubMed、Embase 和 Cochrane 图书馆数据库中检索了 2021 年 8 月之前的相关随机对照试验。最终，纳入了 10 项涉及 872 名受试者的试验。对研究的方法学质量进行了评估，并提取了两个主要和四个次要结果的数据。我们使用标准化平均差 (SMD) 来衡量相同的结果，效应大小的精度报告为 95% 置信区间 (CI)。我们发现，CBT 对立即降低疼痛强度（SMD：-0.54 [CI：-0.9，-0.19]， p  = 0.003）、干预后 3 个月（SMD：-0.55；[CI：-1.01，p = 0.003）具有显着的积极作用。−0.1]，p  = 0.02）和干预后 12 个月（SMD：-0.32；[CI：-0.56，-0.08]，p  = 0.008）。CBT 还减轻了胃肠道症状、抑郁和焦虑的严重程度，提高了生活质量并降低了总社会成本。未来的研究应考虑对对照组进行统一干预并比较不同的 CBT 实施方法。