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自我管理干预在溃疡性结肠炎中的潜在作用:溃疡性结肠炎催眠治疗试验的简要报告。

The potential role of a self-management intervention for ulcerative colitis: a brief report from the ulcerative colitis hypnotherapy trial.

机构信息

Center for Psychosocial Research in GI, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.

出版信息

Biol Res Nurs. 2012 Jan;14(1):71-7. doi: 10.1177/1099800410397629. Epub 2011 Feb 28.

Abstract

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.

摘要

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。

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