Ringel Y, Drossman D A
Functional Gastrointestinal and Motility Disorders Center, University of North Carolina School of Medicine, Chapel Hill 27599-7080, USA.
Surg Clin North Am. 2001 Feb;81(1):231-52, x. doi: 10.1016/s0039-6109(05)70283-8.
In clinical practice, significant discrepancies occur between disease activity and severity, and the patient's symptom experience and behavior. Discrepancies cannot be explained by biologic or morphologic findings, and usually are considered to be related to psychosocial factors. Recent advances in the scientific understanding of the relationship between environmental stress and the neural, endocrine, and immune systems, combined with new methodologies in clinical research, provide a challenging opportunity for clinicians and researchers to establish a more comprehensive understanding of Crohn's disease. This article reviews the important relationship of psychosocial factors, pathogenesis, clinical expression, response to treatment, and outcome of Crohn's disease, and presents a comprehensive model of illness, disease, and ways to integrate psychosocial factors with diagnosis and patient care.
在临床实践中，疾病活动度与严重程度、患者的症状体验及行为之间存在显著差异。这些差异无法用生物学或形态学发现来解释，通常被认为与心理社会因素有关。对环境应激与神经、内分泌和免疫系统之间关系的科学理解取得的最新进展，结合临床研究中的新方法，为临床医生和研究人员提供了一个具有挑战性的机会，以更全面地了解克罗恩病。本文回顾了心理社会因素与克罗恩病的发病机制、临床表现、治疗反应及预后之间的重要关系，并提出了一个关于疾病、病症以及将心理社会因素与诊断和患者护理相结合的方法的综合模型。
