心身模式处置溃疡性结肠炎缓解期合并功能症状60例的临床研究  

Clinical study on psychosomatic model in the management of 60 cases of the functional symptoms complicated with ulcerative colitis in remission

作　　者：任雪霞[1] 张巧丽 曹建新[1] Ren Xuexia, Zhang Qiaoli, Cao Jianxin.(Department of Gastroenterology, The First Peoplels Hospital of Changzhou, Changzhou 213003 , China)

机构地区：[1]常州市第一人民医院消化内科,江苏省213003

出　　处：《中华消化杂志》2018年第9期609-612,共4页Chinese Journal of Digestion

摘　　要：目的 通过分析再归因认知心理治疗联合抗抑郁药物干预UC合并的功能症状的疗效,探讨将社会心理变量纳入临床思考和实践的心身消化病模式.方法 纳入2016年3月至2017年4月符合入选条件的U C患者60例,简单随机分为对照组和观察组各30例,两组均予口服美沙拉秦治疗,观察组进一步行心理加抗抑郁药物干预.两组在纳入研究时和治疗4周后均进行临床症状和焦虑自评量表（SAS）、抑郁自评量表（SDS）评估,以判定疗效.统计学分析采用卡方检验或t检验.结果 60例患者中,47例（78.3％）符合心身医学研究诊断标准的4个综合征,两组各综合征例数分布差异无统计学意义（P〉0.05）.治疗4周后,观察组和对照组的总有效率分别为93.3％（28/30）和53.3％（16/30）,差异有统计学意义（χ2=22.667,P〈0.05）.治疗前与治疗4周后,观察组的SAS评分分别为（54.50±6.70）和（41.07±3.72）分,差异有统计学意义（t=9.595,P=0.005）;对照组SAS评分分别为（54.30±6.06）和（51.90±7.92）分,差异无统计学意义（P=0.195）.治疗前与治疗4周后,观察组的SDS评分分别为（50.63±6.29）和（34.40±4.58）分,差异有统计学意义（t=11.426,P=0.025）;对照组SDS评分分别为（50.03±6.02）和（43.47±6.81）分,差异无统计学意义（P=0.307）.结论 心身整体干预模式能明显改善UC合并的功能症状,将社会心理变量纳入临床思考和实践的心身消化病模式是有意义的.Objective To investigate the efficacy of combination of reattribution cognitive psychotherapy and low-dose antidepressants in the treatment of ulcerative colitis （UC） complicated with functional symptoms , and to explore the psychosomatic digestive disease pattern that incorporated psychosocial variables into clinical thinking and practice .Methods From March 2016 to April 2017 ,sixty patients with UC who met the admission criteria were randomly divided into control group and observation group with 30 patients in each group .Both groups were treated with oral mesalazine ,and the observation group was further treated with reattribution cognitive psychotherapy and antidepressants . Clinical symptoms ,self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were applied to assess the efficacy at the time of enrollment and four weeks after treatment in both groups .Chi square test or t test was performed for statistical analysis .Results Among the 60 patients ,47 （78 .3% ） met four syndromes of diagnostic criteria for phychosomatic research , and there was no statistically significant difference in the case number of each syndrome between the two groups （P〉 0 .05） .After four weeks treatment ,the total effective rates of observation group and control group was 93 .3% （28/30 ） and 53 .3% （16/30） ,respectively ,and the difference was statistically significant （χ2 = 22 .667 ,P〈 0 .05） . Before and four weeks after treatment , the SAS scores of observation group were 54 .50 ± 6 .70 and 41 .07 ± 3 .72 ,respectively ,and the difference was statistically significant （t=9 .595 ,P= 0 .005） .The SAS scores of control group were 54 .30 ± 6 .06 and 51 .90 ± 7 .92 ,respectively ,and the difference was not statistically significant （P=0 .195） .Before and four weeks after treatment ,the SDS scores of observation group were 50 .63 ± 6 .29 and 34 .40 ± 4 .58 ,respectively ,and the difference was statistically significant （t=11 .426 ,P=0 .025） .The SDS scores of cont

关 键 词：结肠炎 溃疡性 炎性肠疾病 抗抑郁药 功能症状 心身模式 

分 类 号：R574.62[医药卫生—消化系统]