肠易激综合征的减压和心理治疗:范围界定综述

Anjali J. T. Fernandes, Anna L. Farrell, Sara V. Naveh, Subhankar Chakraborty
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摘要

肠易激综合征(IBS)是一种高发的功能性胃肠道疾病,通常与心理并发症和适应不良的思维模式有关。以往的研究表明,认知行为疗法(CBT)和肠道引导疗法(GDP)等心理疗法可改善肠易激综合征的症状控制和生活质量。本综述旨在了解各种心理疗法在不同治疗方法中对肠易激综合征患者的疗效。我们对PubMed上重点介绍肠易激综合征心理和减压疗法的文章进行了范围性文献综述。标题和摘要筛选共纳入了 120 项研究。筛选出 32 项研究进行全文综述。调查以减压和认知疗法为重点的心理疗法对缓解胃肠道疾病患者症状的益处的一级和二级研究符合综述的纳入标准。所有 12 项综述研究均报告称,心理疗法对肠易激综合征症状的改善具有统计学意义。8 项研究还涉及了生活质量,并报告称干预组的生活质量在统计学上有明显改善。3 项研究表明,干预组的症状在 12 个月后得到了持续改善。2 项研究对不同类型的心理疗法进行了比较,结果表明,与对照组相比,干预组的症状有所改善,但不同心理疗法之间无明显差异。6 项研究比较了面对面治疗与最少接触治疗或电话治疗,结果显示临床结果无差异。据报道,心理疗法对肠易激综合征症状和患者生活质量的改善具有统计学意义,但不同医疗保健服务形式之间的差异无统计学意义。据报道,大多数改善都能长期持续。需要对更广泛的人群进行进一步研究,以评估心理疗法的经济成本及其对服务不足社区的影响。
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Stress reduction and psychological therapy for IBS: a scoping review
Irritable Bowel Syndrome (IBS) is a highly prevalent functional gastrointestinal disease that is commonly associated with psychological comorbidities and maladaptive thought patterns. Previous studies report psychological therapies such as cognitive behavioral therapy (CBT) and gut-directed therapy (GDP) improve IBS symptom management and quality of life. This review seeks to understand the effectiveness of various psychotherapies across delivery methods for patients with irritable bowel syndrome.A scoping literature review of PubMed articles highlighting psychological and stress reduction treatments for IBS was conducted. 120 studies were included in the title and abstract screening. 32 studies were selected for full text review. Primary and secondary research studies that investigated the benefit of psychological therapies focusing on stress reduction and cognitive therapies for patients with gastrointestinal condition’s symptom relief met inclusion criteria for the review. 12 studies were selected for inclusion.All 12 reviewed studies reported statistically significant improvements in IBS symptoms with psychological therapies. 8 studies also addressed quality of life and reported statistically significant improvement in intervention groups. 3 studies demonstrated persistent improvement after 12 months. 2 studies compared different types of psychotherapies and reported improvements compared to control groups but no significant differences between psychotherapies. 6 studies that compared face to face therapy with minimal contact or telephone therapy showed no difference in clinical outcomes.Psychological therapies demonstrate reported statistically significant improvements in IBS symptoms and patient quality of life with no reported statistically significant difference across forms of healthcare delivery. Most improvements reportedly persist long-term. Further research with a broader demographic base is needed to assess the economic costs of psychological therapies and their implications for underserved communities.
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