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使用催眠疗法实现功能性消化不良的长期改善。

Long-term improvement in functional dyspepsia using hypnotherapy.

作者信息

Calvert Emma Louise, Houghton Lesley Anne, Cooper Patricia, Morris Julie, Whorwell Peter James

机构信息

Department of Medicine, Wythenshawe Hospital, Southmoor Road, Manchester, United Kingdom.

出版信息

Gastroenterology. 2002 Dec;123(6):1778-85. doi: 10.1053/gast.2002.37071.

Abstract

BACKGROUND & AIMS: We have shown hypnotherapy (HT) to be effective in irritable bowel syndrome, with long-term improvements in symptomatology and quality of life (QOL). This study aimed to assess the efficacy of HT in functional dyspepsia (FD).

METHODS

A total of 126 FD patients were randomized to HT, supportive therapy plus placebo medication, or medical treatment for 16 weeks. Percentage change in symptomatology from baseline was assessed after the 16-week treatment phase (short-term) and after 56 weeks (long-term) with 26 HT, 24 supportive therapy, and 29 medical treatment patients completing all phases of the study. QOL was measured as a secondary outcome.

RESULTS

Short-term symptom scores improved more in the HT group (median, 59%) than in the supportive (41%; P = 0.01) or medical treatment (33%; P = 0.057) groups. HT also benefited QOL (42%) compared with either supportive therapy (10% [P < 0.001]) or medical treatment (11% [P < 0.001]). Long-term, HT significantly improved symptoms (73%) compared with supportive therapy (34% [P < 0.02]) or medical treatment (43% [P < 0.01]). QOL improved significantly more with HT (44%) than with medical treatment (20% [P < 0.001]). QOL did improve in the supportive therapy (43%) group, but 5 of these patients commenced taking antidepressants during follow-up. A total of 90% of the patients in the medical treatment group and 82% of the patients in the supportive therapy group commenced medication during follow-up, whereas none in the HT group did so (P < 0.001). Those in the HT group visited their general practitioner or gastroenterologist significantly less (median, 1) than did those in the supportive therapy (median, 4) and medical treatment (median, 4) groups during follow-up (P < 0.001).

CONCLUSIONS

HT is highly effective in the long-term management of FD. Furthermore, the dramatic reduction in medication use and consultation rate provide major economic advantages.

摘要

背景与目的

我们已证明催眠疗法(HT)对肠易激综合征有效,可长期改善症状和生活质量(QOL)。本研究旨在评估HT对功能性消化不良(FD)的疗效。

方法

总共126例FD患者被随机分为接受HT组、支持性治疗加安慰剂组或药物治疗组,为期16周。在为期16周的治疗阶段(短期)结束后以及56周(长期)后,评估26例接受HT、24例接受支持性治疗和29例接受药物治疗且完成研究所有阶段的患者症状从基线的变化百分比。将生活质量作为次要结果进行测量。

结果

短期来看,HT组症状评分改善程度(中位数为59%)高于支持性治疗组(41%;P = 0.01)或药物治疗组(33%;P = 0.057)。与支持性治疗(10% [P < 0.001])或药物治疗(11% [P < 0.001])相比,HT对生活质量也有益(42%)。长期来看,与支持性治疗(34% [P < 0.02])或药物治疗(43% [P < 0.01])相比,HT显著改善症状(73%)。HT组生活质量改善程度(44%)显著高于药物治疗组(20% [P < 0.001])。支持性治疗组生活质量也有所改善(43%),但其中5例患者在随访期间开始服用抗抑郁药。药物治疗组90%的患者和支持性治疗组82%的患者在随访期间开始用药,而HT组无一例如此(P < 0.001)。随访期间,HT组患者看全科医生或胃肠病专家的次数显著少于支持性治疗组(中位数为4次)和药物治疗组(中位数为4次)(中位数为1次)(P < 0.001)。

结论

HT对FD的长期管理非常有效。此外,药物使用和就诊率的大幅降低具有重大经济优势。

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