A randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis
A randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis
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DOI：
10.1016/s0304-3959(00)00449-8
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发表时间：
2001-04-01
期刊：
影响因子：
7.4
通讯作者：
Amsel, R
中科院分区：
文献类型：
--
作者：
Bergeron, S;Binik, YM;Amsel, R
本研究比较了认知行为治疗（12周试验）、表面肌电生物反馈（12周试验）和前庭切除术治疗外阴前庭炎引起的性交困难。受试者为78名妇女，随机分配到三种治疗条件之一中，并在治疗前、治疗后和6个月随访时通过妇科检查、结构化访谈和有关疼痛的标准问卷进行评估（疼痛分级指数和麦吉尔疼痛问卷的感觉量表、前庭疼痛指数、性交疼痛）、性功能（性史表，性交频率，Derogatis性功能量表的信息子量表）和心理调整（简明症状量表）。与治疗前相比，所有治疗组的研究完成者在治疗后和6个月随访时报告疼痛测量值在统计学上显著降低，尽管前庭切除术组比其他两组更成功。然而.前庭切除术的明显优势需要谨慎解释，因为七名被分配到这种情况的妇女没有继续进行干预。从治疗前到h个月随访，三组患者的心理适应和性功能指标均有显著改善。意向治疗分析支持按接受治疗分析结果的一般模式。研究结果表明，性交困难的妇女可以受益于医疗和行为干预。(C)2001年国际疼痛研究协会。由Elsevier Science B.V.出版，版权所有。
This study compared group cognitive-behavioral therapy (12-week trial), surface electromyographic biofeedback (12-week trial), and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Subjects were 78 women randomly assigned to one of three treatment conditions and assessed at pretreatment, posttreatment and 6-month follow-up via gynecological examinations, structured interviews and standard questionnaires pertaining to pain (Pain Rating Index and Sensory scale of the McGill Pain Questionnaire, vestibular pain index, pain during intercourse), sexual function (Sexual History Form, frequency of intercourse, Information subscale of the Derogatis Sexual Functioning Inventory), and psychological adjustment (Brief Symptom Inventory). As compared with pretreatment, study completers of all treatment groups reported statistically significant reductions on pain measures at posttreatment and 6-month follow-up, although the vestibulectomy group was significantly more successful than the two other groups. However. the apparent superiority of vestibulectomy needs to be interpreted with caution since seven women who had been assigned to this condition did not go ahead with the intervention. All three groups significantly improved on measures of psychological adjustment and sexual function from pretreatment to h-month follow-up. Intent-to-treat analysis supported the general pattern of results of analysis by-treatment-received. Findings suggest that women with dyspareunia can benefit from both medical and behavioral interventions. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.