无麸质饮食对乳糜泻的影响：使用 NIH 患者报告结局测量工具（PROMIS、NTCB 和 Neuro-QoL）对两例病例的综合评估。

The Impact of a Gluten-Free Diet on Celiac Disease: A Comprehensive Evaluation of Two Cases Using NIH Patient Reported Outcome Measures (PROMIS, NTCB, and Neuro-QoL).

机构信息

Department of Psychology, University of Central Florida, Orlando, USA.

Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Building 99, Ste. 320, Orlando, FL, 32816, USA.

出版信息

J Clin Psychol Med Settings. 2020 Sep;27(3):444-453. doi: 10.1007/s10880-020-09698-5.

DOI:10.1007/s10880-020-09698-5

PMID:31970587

Abstract

The aim of this study is to demonstrate the effectiveness of the gluten-free diet (GFD) for celiac disease (CD) in a multidisciplinary outpatient Gastroenterology clinic with two adult cases using the innovative, paradigm-shifting measurement systems: The NIH Patient reported outcome measures (PROs). CD results in gastrointestinal (GI) dysfunction, but is also associated with other inflammatory responses, psychosocial impairment, and cognitive deficits such as "brain fog." Adherence to the GFD for 6 months was associated with improvement in specific GI symptoms in one case (PROMIS-GI; Case 2) and improvement in cognitive functioning (NIH Toolbox Cognitive Battery) and psychosocial functioning (Neuro-QOL) in both cases. Notably, improvement in cognitive flexibility occurred in both younger and an older adult patient. This suggests that cognitive decline and the psychosocial deficits associated with CD are reversible with GFD. The NIH PROs were found to be effective, sensitive to change, and minimally disruptive to clinic operations.

摘要

本研究旨在展示在一家多学科的门诊胃肠病学诊所中，使用创新的、具有范式转移意义的测量系统——NIH 患者报告结局测量（PROs），对成人两例乳糜泻（CD）患者进行无麸质饮食（GFD）治疗的效果。CD 可导致胃肠道（GI）功能障碍，但也与其他炎症反应、心理社会障碍和认知缺陷（如“脑雾”）相关。在本研究中，有一例患者（PROMIS-GI；病例 2）在坚持 GFD 治疗 6 个月后，其特定的 GI 症状得到了改善，两例患者的认知功能（NIH 工具包认知电池）和心理社会功能（Neuro-QOL）都得到了改善。值得注意的是，认知灵活性的改善发生在年轻和老年患者中。这表明，与 CD 相关的认知能力下降和心理社会缺陷是可以通过 GFD 逆转的。研究发现，NIH PROs 具有有效性、对变化敏感且对临床操作的干扰最小。