18.10.2006
Treatment of non-cardiac chest pain
Cette étude apporte des premiers arguments sur l’intérêt de l’hypnothérapie dans une population sélectionnée de patients souffrant de douleur thoracique non cardiaque (DTNC).
Background : Non-cardiac chest pain (NCCP) is an extremely debilitating condition of uncertain origin which is difficult to treat and consequently has a high psychological morbidity. Hypnotherapy has been shown to be effective in related conditions such as irritable bowel syndrome where its beneficial effects are long lasting.
Aims : This study aimed to assess the efficacy of hypnotherapy in a selected group of patients with angina-like chest pain in whom coronary angiography was normal and oesophageal reflux was not contributory.
Patients and methods : Twenty eight patients fulfilling the entry criteria were randomised to receive, after a four week baseline period, either 12 sessions of hypnotherapy or supportive therapy plus placebo medication over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were a change in scores for quality of life, pain severity, pain frequency, anxiety, and depression, as well as any alteration in the use of medication.
Results : Twelve of 15 (80%) hypnotherapy patients compared with three of 13 (23%) controls experienced a global improvement in pain (p = 0.008) which was associated with a significantly greater reduction in pain intensity (p = 0.046) although not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage. There were no differences favouring hypnotherapy with respect to anxiety or depression scores.
Conclusion : Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.
H Jones,
Departments of Medicine and Cardiology, Wythenshawe Hospital, Manchester, UK
Correspondence to : Professor P J Whorwell
Education and Research Centre, Wythenshawe Hospital,Southmoor Rd, Wythenshawe
Manchester M23 9LT, UK; eMail
Published Online First: 20 April 2006. Gut 2006;55:1403-1408
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