Augmentation of Interstitial Cystitis-Bladder Pain Syndrome Treatment With Meditation and Yoga: A Randomized Controlled Trial.

IF 4.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY Obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2025-01-02 DOI:10.1097/AOG.0000000000005820

Angela N Dao, Yuko M Komesu, Sierra M Jansen, Timothy R Petersen, Kate V Meriwether

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Abstract

Objective: To investigate whether yoga and meditation added to usual care improves treatment response in women with interstitial cystitis-bladder pain syndrome.

Methods: This randomized trial compared women with interstitial cystitis-bladder pain syndrome receiving standard care alone (control group) with those receiving standard care plus meditation and yoga (mind-body group). Standard care was defined as behavioral changes or medications recommended by the American Urological Association. Individuals in the control group received standard care, and those in the mind-body group received standard care augmented with a commercially available meditation application and standardized yoga tutorial video. Both groups continued their current interstitial cystitis-bladder pain syndrome standard care treatments. The primary outcome was the modified GRA (Global Response Assessment), comparing responders (moderately, markedly improved) with nonresponders at 12 weeks. On power analysis assuming α=5% and β=80%, a sample size of 82 participants was required to find 30% difference on the GRA between groups. Weekly GRA scores over 12 weeks were also compared. Secondary outcomes included ICPI (Interstitial Cystitis Problem Index)/ICSI (Interstitial Cystitis Symptom Index), pain, pain interference, anxiety/depression, and self-efficacy scores and treatment escalation over 12 weeks.

Results: Among 97 randomized participants (49 mind-body group, 48 control group), groups did not differ in characteristics or symptoms at baseline. The mind-body group had more GRA responders compared with the control group at 12 weeks (31/43 [72.1%] vs 10/39 [25.6%], relative risk [RR] 2.8, 95% CI, 1.6-4.6), corroborated by superior weekly GRA results over 12 weeks. The mind-body group had superior beneficial change on the ICPI (RR 1.8, 95% CI, 0.5-3.1), ICSI (RR 1.9, 95% CI, 0.2-3.6), and pain (RR 1.4, 95% CI, 0.4-2.5) scores than the control group at 12 weeks. The mind-body group required less treatment escalation than the control group (2/45 [4.4%] vs 14/42 [33.3%], RR 0.13, 95% CI, 0.03-0.55).

Conclusion: The addition of meditation and yoga to standard interstitial cystitis-bladder pain syndrome care was associated with improved treatment response and required fewer additional interventions compared with standard care alone.

Clinical trial registration: ClinicalTrials.gov, NCT04820855.

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冥想和瑜伽治疗间质性膀胱炎-膀胱疼痛综合征：一项随机对照试验。

目的：探讨瑜伽和冥想在常规护理的基础上是否能改善间质性膀胱炎-膀胱痛综合征患者的治疗效果。方法：该随机试验比较了单纯接受标准治疗的间质性膀胱炎-膀胱痛综合征女性（对照组）和接受标准治疗加冥想和瑜伽的女性（身心组）。标准治疗被定义为行为改变或美国泌尿学协会推荐的药物。对照组接受标准治疗，身心组接受标准治疗，并辅以商业上可获得的冥想应用程序和标准化瑜伽教程视频。两组均继续目前的间质性膀胱炎-膀胱疼痛综合征标准护理治疗。主要结果是改良的GRA（全球反应评估），比较12周时的反应者（中度、显著改善）和无反应者。在假设α=5%和β=80%的功率分析中，需要82名参与者的样本量才能发现组间GRA差异的30%。还比较了12周内的每周GRA评分。次要结局包括ICPI（间质性膀胱炎问题指数）/ICSI（间质性膀胱炎症状指数）、疼痛、疼痛干扰、焦虑/抑郁、自我效能评分和12周内的治疗升级。结果：在97名随机参与者中（49名身心组，48名对照组），各组在基线时的特征或症状没有差异。与对照组相比，心身组在12周时有更多的GRA应答者（31/43 [72.1%]vs 10/39[25.6%]，相对风险[RR] 2.8, 95% CI, 1.6-4.6）， 12周期间的每周GRA结果优于对照组。在12周时，身心组在ICPI （RR 1.8, 95% CI, 0.5-3.1）、ICSI （RR 1.9, 95% CI, 0.2-3.6）和疼痛（RR 1.4, 95% CI, 0.4-2.5）评分上的有益改变优于对照组。心身组比对照组需要更少的治疗升级（2/45[4.4%]比14/42 [33.3%],RR 0.13, 95% CI, 0.03-0.55）。结论：在标准间质性膀胱炎-膀胱疼痛综合征护理中加入冥想和瑜伽与改善治疗反应相关，与单独的标准护理相比，需要更少的额外干预。临床试验注册：ClinicalTrials.gov, NCT04820855。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obstetrics and gynecology 医学-妇产科学

CiteScore

11.10

自引率

4.20%

发文量

867

审稿时长

1 months

期刊介绍： "Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics. "Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.