军事卫生系统中疼痛的补充和综合健康的疗效和利用综述。

IF 1.7 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Abigail K Crosier, Erin Tracy, Austin G Bell, Kathryn M Eliasen, Thomas J Peterson, Rhonda J Allard, Tracy L Rupp
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引用次数: 0

摘要

简介:本综述评估了补充和综合健康(CIH)疗法在军事卫生系统(MHS)疼痛管理中的功效/有效性和利用。具体来说,它旨在评估基于证据的模式,如针灸、生物反馈、催眠、按摩疗法、冥想、引导意象、太极/气功和瑜伽,这些都是退伍军人管理局(VA)整体健康计划的一部分。目的是确定其在军事服务成员中的有效性,了解其在MHS中的使用情况,并探索MHS中的CIH研究以确定差距。方法:综合检索PubMed、Embase和Ovid All EBM Reviews数据库,检索2014年1月1日至2024年3月22日发表的研究。研究集中在与军事人群疼痛管理相关的CIH疗法上,共获得433项研究。筛选合格后,纳入53项研究进行详细回顾。研究包括随机对照试验、案例研究、大型数据库分析和回顾性图表回顾。排除标准排除了非同行评议的、与疼痛无关的、与预先指定的CIH模式(针灸、生物反馈、催眠、按摩疗法、冥想、引导想象、太极/气功和瑜伽)无关的文章,以及那些与MHS无关的文章。由于研究设计的异质性,本综述未解决偏倚问题。结果:该综述确定了支持CIH模式用于疼痛管理的重要证据。针灸,特别是战地针灸,显示出急性和慢性疼痛的疼痛评分立即降低。按摩疗法和生物反馈的研究表明,在减轻疼痛和改善各种肌肉骨骼和压力相关疾病的功能结果方面,按摩疗法和生物反馈是有效的。冥想和瑜伽被证明对慢性疼痛、压力管理和提高整体幸福感有效。利用数据表明,在军事设施中,CIH治疗的使用稳步增加。讨论:CIH疗法,特别是针灸,按摩疗法和瑜伽,似乎是有效的非药物干预疼痛管理在军人人群。它们越来越多的使用反映了人们对它们在治疗慢性疼痛和提高服务人员生活质量方面的好处的认识。需要进一步的研究来规范整个MHS的实践和优化利用。协议注册:PROSPERO 2024 CRD4202453685, 2024年4月29日,https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024536853。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Scoping Review on the Efficacy/Effectiveness and Utilization of Complementary and Integrative Health for Pain in the Military Health System.

Introduction: This scoping review evaluated the efficacy/effectiveness and utilization of complementary and integrative health (CIH) therapies for pain management within the Military Health System (MHS). Specifically, it aimed to assess evidence-based modalities such as acupuncture, biofeedback, hypnosis, massage therapy, meditation, guided imagery, Tai Chi/Qi Gong, and yoga, which are part of the Veterans Administration's (VA) Whole Health program. The goal was to determine their effectiveness in military service members and understand their utilization in the MHS, as well as explore CIH research in the MHS to identify gaps. Methods: A comprehensive search of PubMed, Embase, and Ovid All EBM Reviews databases was conducted for studies published from January 1, 2014 to March 22, 2024. The search focused on CIH therapies related to pain management in military populations, yielding 433 studies. After screening for eligibility, 53 studies were included for detailed review. Studies included randomized controlled trials, case studies, large database analyses, and retrospective chart reviews. Exclusion criteria eliminated nonpeer-reviewed articles, not pain-related, not related to one of the prespecified CIH modalities (acupuncture, biofeedback, hypnosis, massage therapy, meditation, guided imagery, Tai Chi/Qi Gong, and yoga), and those not specific to the MHS. The review did not address bias due to the heterogeneity of study designs included. Results: The review identified significant evidence supporting the use of CIH modalities for pain management. Acupuncture, particularly Battlefield Acupuncture, showed immediate reduction in pain score for both acute and chronic pain. Studies of massage therapy and biofeedback demonstrated efficacy/effectiveness in reducing pain and improving functional outcomes in various musculoskeletal and stress-related disorders. Meditation and yoga were shown to be effective for chronic pain, stress management, and enhancing overall well-being. Utilization data indicated a steady increase in CIH therapy use across military facilities. Discussion: CIH therapies, particularly acupuncture, massage therapy, and yoga, appear to be effective nonpharmacologic interventions for pain management in military populations. Their growing utilization reflects the recognition of their benefits in managing chronic pain and improving quality of life among service members. Further research is needed to standardize practices and optimize utilization across the MHS. Registration of Protocol: PROSPERO 2024 CRD4202453685, 29 April 2024, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024536853.

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