Center for Psychosocial Research in GI, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Biol Res Nurs. 2012 Jan;14(1):71-7. doi: 10.1177/1099800410397629. Epub 2011 Feb 28.
Inflammatory bowel diseases (IBD) are chronic inflammatory illnesses marked by unpredictable disease flares, which occur spontaneously and/or in response to external triggers, especially personal health behaviors. Behavioral triggers of flare may be responsive to disease self-management programs. We report on interim findings of a randomized controlled trial of gut-directed hypnotherapy (HYP, n = 19) versus active attention control (CON, n = 17) for quiescent ulcerative colitis (UC). To date, 43 participants have enrolled; after 5 discontinuations (1 in HYP) and 2 exclusions due to excessive missing data, 36 were included in this preliminary analysis. Aim 1 was to determine the feasibility and acceptability of HYP in UC. This was achieved, demonstrated by a reasonable recruitment rate at our outpatient tertiary care clinic (20%), high retention rate (88% total), and our representative IBD sample, which is reflected by an equal distribution of gender, an age range between 21 and 69, recruitment of ethnic minorities (∽20%), and disease duration ranging from 1.5 to 35 years. Aim 2 was to estimate effect sizes on key clinical outcomes for use in future trials. Effect sizes (group × time at 20 weeks) were small to medium for IBD self-efficacy (.34), Inflammatory Bowel Disease Questionnaire (IBDQ) total score (.41), IBDQ bowel (.50), and systemic health (.48). Between-group effects were observed for the IBDQ bowel health subscale (HYP > CON; p = .05) at 20 weeks and the Short Form 12 Health Survey Version 2 (SF-12v2) physical component (HYP > CON; p < .05) at posttreatment and 20 weeks. This study supports future clinical trials testing gut-directed HYP as a relapse prevention tool for IBD.
炎症性肠病(IBD)是一种慢性炎症性疾病,其特点是疾病发作不可预测,这些发作自发发生和/或对外部诱因(尤其是个人健康行为)作出反应。发作的行为诱因可能对疾病自我管理计划有反应。我们报告了一项针对静止性溃疡性结肠炎(UC)的靶向肠道催眠治疗(HYP,n=19)与积极对照(CON,n=17)的随机对照试验的中期结果。迄今为止,已有 43 名参与者入组;在 5 名患者退出(HYP 组 1 名)和 2 名因数据缺失过多而被排除后,共有 36 名患者纳入本初步分析。目的 1 是确定 HYP 在 UC 中的可行性和可接受性。这一目标已经实现,这体现在我们在门诊三级保健诊所的合理招募率(20%)、高保留率(总保留率 88%),以及我们具有代表性的 IBD 样本,其中包括性别分布均衡、年龄在 21 至 69 岁之间、招募少数民族(约 20%)和疾病持续时间从 1.5 年到 35 年不等。目的 2 是估计关键临床结果的效应大小,以便在未来的试验中使用。在 20 周时,IBD 自我效能感(.34)、炎症性肠病问卷(IBDQ)总分(.41)、IBDQ 肠病(.50)和系统健康(.48)的效应大小(组×20 周时)为小至中等。在 20 周时观察到 HYP 组与 CON 组之间 IBDQ 肠病健康子量表存在组间差异(HYP>CON;p=0.05),在治疗后和 20 周时观察到健康调查简表 12 项版本 2(SF-12v2)的生理成分(HYP>CON;p<0.05)存在组间差异。这项研究支持未来的临床试验,以测试靶向肠道的 HYP 作为 IBD 的复发预防工具。