Anton P A
UCLA Department of Medicine, Los Angeles, CA, USA.
Semin Gastrointest Dis. 1999 Jan;10(1):14-9.
At present, the medical management of inflammatory bowel diseases (IBD) including Crohn's disease and ulcerative colitis, are focused on topical, locally active antiinflammatories and systemic immunosuppressives, which are thought to exert their targeted effects in the gastrointestinal mucosa. There is a paucity of controlled trials assessing the impact of mind, central nervous system (CNS), and neuromodulation on the overly active immune response in the intestinal mucosa. Patients and their physicians have long been aware of a strong association between attitude, stress, and flares of their IBD. Although reports to date remain mostly anecdotal, the degree to which mind-body influences and stress impact levels of local inflammation deserves closer attention with the aim of identifying contributing mechanisms, which may highlight new therapeutic interventions, as well as assist in identifying particular subsets of patients that may respond to novel forms of adjunctive treatments for IBD, including hypnosis, meditation, neuropeptide receptor modulation, and cortisol-releasing factor (CRF) modulation.
目前，包括克罗恩病和溃疡性结肠炎在内的炎症性肠病（IBD）的药物治疗主要集中在局部活性抗炎药和全身免疫抑制剂上，这些药物被认为在胃肠道黏膜发挥靶向作用。评估心理、中枢神经系统（CNS）和神经调节对肠黏膜过度活跃免疫反应影响的对照试验很少。患者及其医生早就意识到IBD患者的态度、压力与病情发作之间存在密切关联。尽管迄今为止的报告大多是轶事性的，但身心影响和压力对局部炎症水平的影响程度值得密切关注，目的是确定其作用机制，这可能会突出新的治疗干预措施，并有助于识别可能对IBD新型辅助治疗（包括催眠、冥想、神经肽受体调节和促肾上腺皮质激素释放因子（CRF）调节）有反应的特定患者亚群。
