冥想
取决于患者在冥想时的动机和技巧,可能显著减轻疼痛。[43]Champaneria R, Daniels JP, Raza A, et al. Psychological therapies for chronic pelvic pain: systematic review of randomized controlled trials. Acta Obstet Gynecol Scand. 2012 Mar;91(3):281-6.http://www.ncbi.nlm.nih.gov/pubmed/22050516?tool=bestpractice.com 冥想(通过任何方式,包括瑜伽、太极或超觉冥想)可激活前额皮质,诱导边缘叶结构活动减少,尤其是前扣带回。[44]Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. Pain. 2008 Feb;134(3):310-9.http://www.ncbi.nlm.nih.gov/pubmed/17544212?tool=bestpractice.com[45]Fox SD, Flynn E, Allen RH. Mindfulness meditation for women with chronic pelvic pain: a pilot study. J Reprod Med. 2011 Mar-Apr;56(3-4):158-62.http://www.ncbi.nlm.nih.gov/pubmed/21542535?tool=bestpractice.com
有氧运动
充满活力的长时间(45 分钟或更长)有氧运动可诱导产生脑内啡肽,这种物质可减少上行疼痛信号。这对慢性疼痛可能非常有效。[46]Cote JN, Hoeger Bement MK. Update on the relation between pain and movement: consequences for clinical practice. Clin J Pain. 2010 Nov-Dec;26(9):754-62.http://www.ncbi.nlm.nih.gov/pubmed/20664335?tool=bestpractice.com
集中想象
这是试验版的冥想,在磁共振成像 (MRI) 磁场内进行。使用功能 MRI (fMRI) 序列,测定前扣带皮质 (anterior cingulate cortex, ACC) 的活动,并且产生一幅成比例的篝火模拟图像。然后通过特殊的视频眼镜向 MRI 内的患者出示这幅图像,她试图缩小篝火的大小,此时 fMRI 继续计算 ACC 活动。这个过程依靠前额皮质直接控制前扣带回。患者需要接受大量训练才能完成这项任务,并且需要使用专门配备的 MRI。初步结果令人鼓舞,但大多都支持使用药物控制疼痛。[47]Berna C, Vincent K, Moore J, et al. Presence of mental imagery associated with chronic pelvic pain: a pilot study. Pain Med. 2011 Jul;12(7):1086-93.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444686/http://www.ncbi.nlm.nih.gov/pubmed/21668746?tool=bestpractice.com
昂丹司琼
一项小型、安慰剂对照研究证明,慢性疼痛患者静脉用药后,疼痛显著缓解。 根据推测,这是通过调控边缘叶 5-羟色胺受体起作用。[48]McCleane GJ, Suzuki R, Dickenson AH. Does a single intravenous injection of the 5HT3 receptor antagonist ondansetron have an analgesic effect in neuropathic pain? A double-blinded, placebo-controlled cross-over study. Anesth Analg. 2003 Nov;97(5):1474-8.http://www.ncbi.nlm.nih.gov/pubmed/14570668?tool=bestpractice.com