重归因-认知-药物模式治疗肠易激综合征的临床疗效研究  

Clinical study of reattribution-cognitive-pharmacy model in the treatment for irritable bowel syndrome

作　　者：曹建新[1] 王玉兰[1] 任雪霞[1] 朱国燕[1] 

机构地区：[1]常州市第一人民医院,常州213003

出　　处：《中华行为医学与脑科学杂志》2010年第12期1069-1070,共2页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的探讨重归因-认知-药物整体治疗模式在治疗肠易激综合征中的临床效果。方法125例肠易激综合征（IBS—D）患者分为A、B2组。A组为非重归因-认知-药物模式治疗组，62例，口服帕罗西汀10mg／d，1周后加至20mg／d。不用其他药物，不做心理治疗。B组63例，采用重归因-认知-药物模式（RCPM）治疗。每周会谈1次，第1次会谈≥30min，以后每次≥15min。共6次。第1次会谈后给予帕罗西汀10mg／d，1周后加至20mg／d。结果4周末A组29例腹痛明显减轻，28例便次减少，B组48例腹痛明显减轻，42例便次减少；12周末A组36例腹痛明显减轻，30例便次减少，B组54例腹痛明显减轻，45例便次减少。2组比较差异有统计学意义（P〈0．05）？A组4周末12例停用帕罗西汀，12周末14例停用帕罗西汀；B组4周末3例停用帕罗西汀，12周末5例停用帕罗西汀；2组比较差异有统计学意义（P〈0．05）。结论RCPM能有效减轻肠易激综合征的症状，比单用帕罗西汀效果更明显RCPM能明显提高IBS患者对抗抑郁药物的依从性：Objective To investigate clinical effect of reattribution-cognitive-pharmacy model （RCPM） in the treatment for irritable bowel syndrome （IBS）. Methods 125 subjects with diarrhea predominant irritable bowel syndrome （IBS-D） were divided into two groups randomly,, 62 patients in group A were treated with 10 -20 mg of paroxetine without any other medication or psychological interview and 63patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 - 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain,and 42 reported a reduction in stool frequency,and 3 patients stopped taking paroxefine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B ,54 cases reported a reduction in abdonfinal pain, and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.

关 键 词：肠易激综合征 治疗 重归因-认知-药物 模式 

分 类 号：R574.4[医药卫生—消化系统]