Division of Digestive Diseases, Hepatology, & Nutrition and Division of Pediatric Psychology, Connecticut Children's Medical Center.
University of Connecticut, School of Medicine, Hartford, Connecticut.
Curr Opin Pediatr. 2019 Oct;31(5):630-635. doi: 10.1097/MOP.0000000000000800.
Vomiting can be a primary symptom or associated with various other functional gastrointestinal disorders (FGIDs). The purpose of this review was to discuss the evidence for psychological treatments for vomiting in pediatric FGID.
Vomiting of functional origin is an increasingly recognized symptom among children and adolescents. It is highly aversive and associated with disability and poor quality of life. Cognitive behavioral therapy, lifestyle modification (especially sleep), diaphragmatic breathing, and hypnosis can be helpful in preventing vomiting episodes and reducing disability. However, no randomized clinical trials have been performed. An evidence base for psychological treatments in children with vomiting of functional origin is highly needed.
Increased evidence is demonstrating value and efficacy of incorporating psychogastroenterology practices into ongoing treatment plans for digestive conditions. Current psychological treatments are focused on prevention of vomiting through stress reduction and lifestyle modification, reduction of disability by limiting avoidance behaviours, as well as counteracting biological factors. However, psychological treatments have not been shown to be helpful during an acute vomiting episode. More research is needed to build an evidence base for psychological treatments in vomiting disorders.
呕吐可作为主要症状,也可与各种其他功能性胃肠疾病(FGIDs)相关。本综述的目的是讨论针对儿科 FGID 呕吐的心理治疗证据。
功能性起源的呕吐是儿童和青少年中越来越被认识到的一种症状。它非常令人厌恶,并与残疾和生活质量差有关。认知行为疗法、生活方式改变(尤其是睡眠)、膈式呼吸和催眠术有助于预防呕吐发作和减少残疾。然而,目前还没有进行随机临床试验。非常需要为具有功能性起源的呕吐的儿童提供心理治疗的证据基础。
越来越多的证据表明,将心理胃肠病学实践纳入正在进行的消化疾病治疗计划具有价值和疗效。目前的心理治疗侧重于通过减轻压力和生活方式改变来预防呕吐,通过限制回避行为来减少残疾,以及对抗生物学因素。然而,在急性呕吐发作期间,心理治疗并没有显示出帮助。需要更多的研究来为呕吐障碍的心理治疗建立证据基础。