Houghton L A, Calvert E L, Jackson N A, Cooper P, Whorwell P J
Department of Medicine, University Hospital of South Manchester, Manchester M20 2LR, UK.
Gut. 2002 Nov;51(5):701-4. doi: 10.1136/gut.51.5.701.
We have previously shown that hypnosis can be used to study the effect of different emotions on the motility of the gastrointestinal tract. These studies demonstrated that both anger and excitement increased colonic motility while happiness led to a reduction. The purpose of this study was to investigate the effect of hypnotically induced emotion on the visceral sensitivity of the gut.
Sensory responses to balloon distension of the rectum and compliance were assessed in 20 patients with irritable bowel syndrome (IBS) (aged 17-64 years; 17 female) diagnosed by the Rome I criteria. Patients were studied on four separate occasions in random order either awake (control) or in hypnosis, during which anger, happiness, or relaxation (neutral emotion) were induced.
Hypnotic relaxation increased the distension volume required to induce discomfort (p=0.05) while anger reduced this threshold compared with relaxation (p<0.05), happiness (p<0.01), and awake conditions (p<0.001). Happiness did not further alter sensitivity from that observed during relaxation. There were no associated changes in rectal compliance or wall tension.
Further to our previous observations on motility, this study shows that emotion can also affect an IBS patient's perception of rectal distension and demonstrates the critical role of the mind in modulating gastrointestinal physiology. These results emphasise how awareness of the emotional state of the patient is important when either measuring visceral sensitivity or treating IBS.
我们之前已经表明，催眠可用于研究不同情绪对胃肠道动力的影响。这些研究表明，愤怒和兴奋都会增加结肠动力，而快乐则会导致动力下降。本研究的目的是调查催眠诱导情绪对肠道内脏敏感性的影响。
对20名符合罗马I标准诊断的肠易激综合征（IBS）患者（年龄17 - 64岁；17名女性）进行直肠气囊扩张的感觉反应和顺应性评估。患者在四个不同的时间以随机顺序接受研究，分别是清醒状态（对照）或处于催眠状态，在催眠状态下诱导出愤怒、快乐或放松（中性情绪）。
与放松状态（p = 0.05）相比，催眠放松状态下引起不适所需的扩张体积增加；与放松状态（p < 0.05）、快乐状态（p < 0.01）和清醒状态（p < 0.001）相比，愤怒状态下降低了这一门槛。快乐状态与放松状态相比，并未进一步改变敏感性。直肠顺应性或壁张力没有相关变化。
在我们之前关于动力的观察基础上，本研究表明情绪也会影响IBS患者对直肠扩张的感知，并证明了心理在调节胃肠生理方面的关键作用。这些结果强调了在测量内脏敏感性或治疗IBS时，了解患者情绪状态的重要性。
