Heitkemper Margaret M, Jarrett Monica E, Levy Rona L, Cain Kevin C, Burr Robert L, Feld Andrew, Barney Pam, Weisman Pam
Department of Behavioral Nursing and Health Systems, University of Washington, Seattle, 98195, USA.
Clin Gastroenterol Hepatol. 2004 Jul;2(7):585-96. doi: 10.1016/s1542-3565(04)00242-3.
BACKGROUND & AIMS: A randomized clinical trial was used to test the effectiveness of an 8-session multicomponent program (Comprehensive) compared to a Brief (single session) version and Usual Care for women with irritable bowel syndrome.
Menstruating women, ages 18-48 years, were recruited from a health maintenance organization as well as community advertisements. Psychiatric nurse practitioners delivered both programs. The primary outcomes were improved symptoms, psychological distress, health-related quality of life, and indicators of stress-related hormones. Outcome indicators were measured at 3 points: (1) immediately after the Comprehensive program or 9 weeks after entry into the Usual Care and Brief Self-Management groups, (2) at 6 months, and (3) at 12 months.
Compared to Usual Care, women in the Comprehensive program had reduced gastrointestinal symptoms, psychological distress indicators, interruptions in activities because of symptoms, and enhanced quality of life that persisted at the 12-month follow-up evaluation. Women in the Brief group also demonstrated statistically significant improvements in quality of life and smaller nonsignificant improvements in other outcome variables than observed in the Comprehensive group. There were no group differences in urine catecholamines and cortisol levels.
A comprehensive self-management program is an important therapy approach for women with irritable bowel syndrome. The Brief 1-session version is also moderately helpful for some women with IBS.
采用一项随机临床试验，比较一个为期8节的多组分项目（综合项目）与简短（单节）版本以及常规护理对肠易激综合征女性患者的有效性。
从一家健康维护组织以及社区广告中招募年龄在18 - 48岁的月经周期女性。两个项目均由精神科执业护士实施。主要结局指标包括症状改善、心理困扰、健康相关生活质量以及应激相关激素指标。结局指标在三个时间点进行测量：（1）综合项目结束后即刻，或进入常规护理组和简短自我管理组9周后；（2）6个月时；（3）12个月时。
与常规护理相比，综合项目组的女性胃肠道症状减轻、心理困扰指标降低、因症状导致的活动中断减少，且生活质量提高，这些改善在12个月的随访评估中持续存在。简短组的女性在生活质量方面也有统计学意义的显著改善，在其他结局变量方面的改善虽不如综合组显著但也有一定改善。尿儿茶酚胺和皮质醇水平在各组之间无差异。
综合自我管理项目是肠易激综合征女性患者的一种重要治疗方法。简短的单节版本对一些肠易激综合征女性也有一定帮助。
