用于治疗肠易激综合征和炎症性肠病的接纳与承诺疗法:叙述性综述。

IF 3.8 Q2 GASTROENTEROLOGY & HEPATOLOGY Translational gastroenterology and hepatology Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.21037/tgh-24-10
Sara H Marchese, Jessica P Naftaly, John Pandolfino
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引用次数: 0

摘要

背景和目的:认知行为疗法(CBT)是肠易激综合征(IBS)和炎症性肠病(IBD)患者常用的治疗方式。CBT 可能并不适合所有患者,有些患者可能会从接受和承诺疗法(ACT)中获益。这篇叙述性综述介绍了在 IBS 或 IBD 成年患者中使用 ACT 的证据。作者还提出了 IBS 或 IBD 患者可能从 ACT 中受益的情况,并讨论了未来的研究方向:2023年8月至2024年1月期间,作者使用谷歌学术、机构图书馆和PubMed等数据库查阅了有关IBS和IBD患者ACT的文献。其中包括多种检索词。排除了非英语、儿科以及未采用完整 ACT 方案的研究:针对肠易激综合征的 ACT 研究通常使用自助书籍或为期一天的研讨会进行干预,结果显示肠易激综合征和情绪症状有所减轻,生活质量有所提高。在肠易激综合征方面,有三项随机对照试验(RCT)测试了ACT的影响,其中两项发现压力、抑郁和焦虑症状有所减轻:尽管在肠易激综合征或 IBD 患者群体中测试完整 ACT 方案的研究数量有限,但研究结果表明,ACT 不仅能有效控制症状,还能改善生活质量。未来的研究应采用稳健的实验设计,并通过过程和结果测量来全面测试 ACT 在肠易激综合征和肠道综合征患者群体中的有效性。
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Acceptance and commitment therapy for the treatment of irritable bowel syndrome and inflammatory bowel disease: a narrative review.

Background and objective: Cognitive behavioral therapy (CBT) is a common treatment modality for patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). CBT may not be a good fit for all patients and some may instead benefit from an acceptance and commitment therapy (ACT) approach. This narrative review presents evidence for the use of ACT in adult patients with IBS or IBD. The authors also suggest instances in which patients with IBS or IBD may benefit from ACT and discuss future directions of research.

Methods: Between August 2023 and January 2024, databases such as Google Scholar, institutional libraries, and PubMed were used to review the literature on ACT in patients with IBS and IBD. A variety of search terms were included. Non-English, pediatric, and studies that did not employ a full ACT protocol were excluded.

Key content and findings: ACT for IBS studies typically utilized a self-help book or a one-day workshop intervention, with results indicating reductions in IBS and mood symptoms and improvements in quality of life. Within IBD, three randomized controlled trials (RCTs) tested the impact of ACT, two of which found reductions in stress, depression, and anxiety symptoms.

Conclusions: Despite the limited number of studies testing a full ACT protocol in patient populations with IBS or IBD, results indicate potential efficacy in managing not only symptoms, but also facets of quality of life. Future studies should utilize robust experimental designs and comprehensively test the effectiveness of ACT in IBS and IBD patient populations with both process and outcome measures.

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