身体扫描正念训练在灼口综合征患者中应用效果评价^*

Evaluation of the Effects of Body Scan Mindfulness Training in Patients With Burning Mouth Syndrome

摘要

目的 通过应用身体扫描正念训练对灼口综合征（Burning mouth syndrome, BMS）患者进行干预，评价其临床应用效果。方法 本研究采用随机、对照、盲法评估的临床研究设计方案，利用随机数字表法将通过纳入排除标准筛选的BMS患者分为对照组和试验组。对照组采用药物治疗及常规心理护理措施，试验组在对照组基础上增加2周身体扫描正念训练。在干预前、干预后及干预后3个月采用视觉模拟评分法（Visual Analogue Scale, VAS）、失眠严重指数量表（Insomnia Severity Index, ISI）、广泛性焦虑量表（Generalized Anxiety Disorder-7, GAD-7）、患者健康问卷抑郁量表（Patient Health Questionnaire-9, PHQ-9）及口腔健康影响程度量表（Oral Health Impact Profile-14, OHIP-14）分别评估患者的疼痛程度、睡眠质量、焦虑程度、抑郁程度及口腔健康相关生活质量。通过比较两组干预前后主要结局指标（VAS）及次要结局指标（ISI、GAD-7、PHQ-9及OHIP-14）的变化差异，评估身体扫描正念训练对BMS患者的干预效果。结果 本研究共纳入80例研究对象，失访3例，最终77例（对照组38例，试验组39例）患者纳入分析。干预后试验组VAS、 ISI、GAD-7及PHQ-9减少的差值中位数（P₂₅,P₇₅）分别为2.00 (1.00, 3.00)、3.00 (0.00, 8.00)、3.00 (1.00, 6.75)和 2.00 (0.00, 5.00)，均大于对照组减少的差值〔0.95 (0.00, 2.50)、0.00 (0.00, 3.00) 、1.00 (0.00, 3.25)和1.00 (0.00, 2.00) 〕，差异有统计学意义（P < 0.05）；两组OHIP-14减少的差值差异无统计学意义（ P > 0.05）。干预后及干预后3个月试验组VAS均低于对照组，差异有统计学意义（ P < 0.05）。结论 BMS患者在常规药物治疗的基础上进行身体扫描正念训练，能有效缓解其口腔烧灼样疼痛程度，也有助于改善睡眠质量、缓解焦虑及抑郁情绪，值得在临床中推广应用。

Abstract

Objective To evaluate the clinical efficacy of body scan mindfulness training as an intervention for patients with burning mouth syndrome (BMS). Methods This randomized, controlled, single-blind clinical trial enrolled patients with BMS who met the inclusion and exclusion criteria. Participants were assigned to a control group or an intervention group using a random number table. The control group received pharmacological treatment and routine psychological care, while the intervention group additionally received two weeks of body scan mindfulness training. The Visual Analog Scale (VAS), Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Oral Health Impact Profile (OHIP-14) were used to assess pain intensity, sleep quality, anxiety, depression, and oral health-related quality of life, respectively, at baseline, immediately after the intervention, and 3 months after the intervention. The efficacy of body scan mindfulness training for patients with BMS was evaluated by comparing changes in the primary outcome measure (VAS) and secondary outcome measures (ISI, GAD-7, PHQ-9, and OHIP-14) between the two groups before and after the intervention. Results A total of 80 patients were enrolled in this study; 3 were lost to follow-up, and 77 patients (38 in the control group and 39 in the intervention group) were included in the analysis. The median changes (P₂₅, P₇₅) in VAS, ISI, GAD-7, and PHQ-9 scores after the intervention in the experimental group were 2.00 (1.00, 3.00), 3.00 (0.00, 8.00), 3.00 (1.00, 6.75), and 2.00 (0.00, 5.00), respectively. These were all greater than the corresponding changes in the control group (0.95 [0.00, 2.50], 0.00[0.00, 3.00], 1.00 [0.00, 3.25], and 1.00 [0.00, 2.00]), with statistically significant differences. (P < 0.05). No significant difference was observed in the reduction of OHIP-14 scores between the two groups ( P > 0.05). Both immediately after the intervention and at 3 months post-intervention, the VAS score remained significantly lower in the intervention group than in the control group ( P < 0.05). Conclusion For patients with BMS, implementing body scan mindfulness training alongside conventional drug treatment has proven effective in alleviating the intensity of oral burning pain, improving sleep quality, and reducing anxiety and depression. These findings suggest that body scan mindfulness training is a promising adjuvant therapy for patients with BMS receiving conventional drug treatment, and warrants broader clinical adoption.

关键词

灼口综合征 / 身体扫描 / 正念 / 疼痛

Key words

Burning mouth syndrome / Body scan / Mindfulness / Pain

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基金资助

*四川省心理学会科研规划项目(SCSXLXH2022005)