Janice F Queiroz, Ayane C A Sarmento, Antonio C Q Aquino, Amaxsell Thiago Barros de Souza, Kleyton Santos de Medeiros, Megan L Falsetta, Ana Katherine Gonçalves
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The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4 was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence.</p><p><strong>Results: </strong>A total of 1,884 articles were retrieved. Eight studies met the eligibility criteria and were included in the systematic review, comprising 689 participants. Two studies were included in the meta-analysis, these with 143 participants. When comparing the Acceptance and Commitment Therapy (ACT) with the control group, the mean difference (MD) in the pooled analysis for the Chronic Pain Acceptance Questionnaire did not differ significantly between ACT therapy and other therapies for posttreatment assessment (MD = 0.77; 95% CI = 3.45-4.99). Only 1 study was at high risk of bias due to a lack of clarity about the outcome measurement process. 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引用次数: 0
摘要
目的：评价心理治疗和心理治疗技术在减轻外阴疼痛、改善性功能和心理调节方面的效果。材料和方法：遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。2024年7月19日检索PubMed、Embase、Scopus、Web of Science、Cochrane Central Register of Controlled Trials、PsycInfo和临床试验数据库。我们纳入了比较心理治疗干预和心理治疗技术治疗外阴痛的随机对照试验。使用Cochrane风险偏倚（RoB 2.0）工具评估偏倚风险。使用RevMan 5.4进行数据综合。采用建议分级评估发展（GRADE）和评价方法来评估证据的强度。结果：共检索到1884篇文献。8项研究符合资格标准，纳入系统评价，共有689名参与者。荟萃分析纳入了两项研究，共有143名参与者。在接受与承诺疗法（ACT）与对照组的比较中，慢性疼痛接受问卷合并分析的平均差异（MD）在ACT治疗与其他治疗的治疗后评估中无显著差异(MD = 0.77；95% ci = 3.45-4.99)。只有1项研究由于结果测量过程缺乏明确性而存在高偏倚风险。使用ACT对外阴疼痛接受证据的确定性评分GRADE被认为是低的。结论：心理治疗可显著改善外阴痛患者的外阴疼痛、心理调节及性功能。此外，我们的荟萃分析显示ACT和其他心理治疗干预通过接受疼痛来改善心理调节。然而，需要更严格的研究来提高证据的质量并为临床实践提供信息。
Psychotherapy and Psychotherapeutic Techniques for the Treatment of Vulvodynia: A Systematic Review and Meta-Analysis.
Objectives: To assess the effectiveness of psychotherapy and psychotherapeutic techniques for reduction of vulvar pain and the improvement of sexual function and psychological adjustment in vulvodynia.
Material and methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, PsycInfo, and Clinical Trial Databases were searched on July 19, 2024. We included randomized controlled trials comparing psychotherapy interventions and psychotherapeutic techniques for vulvodynia. The risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool. RevMan 5.4 was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to assess the strength of the evidence.
Results: A total of 1,884 articles were retrieved. Eight studies met the eligibility criteria and were included in the systematic review, comprising 689 participants. Two studies were included in the meta-analysis, these with 143 participants. When comparing the Acceptance and Commitment Therapy (ACT) with the control group, the mean difference (MD) in the pooled analysis for the Chronic Pain Acceptance Questionnaire did not differ significantly between ACT therapy and other therapies for posttreatment assessment (MD = 0.77; 95% CI = 3.45-4.99). Only 1 study was at high risk of bias due to a lack of clarity about the outcome measurement process. The GRADE rating for the certainty of the evidence for vulvar pain acceptance using ACT was considered low.
Conclusions: Psychotherapy significantly improves vulvar pain, psychological adjustment, and sexual function in women with vulvodynia. Additionally, our meta-analysis showed that ACT and other psychotherapeutic interventions improve psychological adjustment through pain acceptance. However, more rigorous studies are needed to improve the quality of evidence and inform clinical practice.
期刊介绍：
The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus.
The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning.
The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care.
The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.
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