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溃疡性结肠炎患者的综合生活方式改变——一项随机对照试验

Comprehensive Lifestyle-Modification in Patients with Ulcerative Colitis-A Randomized Controlled Trial.

作者信息

Langhorst Jost, Schöls Margarita, Cinar Zehra, Eilert Ronja, Kofink Kerstin, Paul Anna, Zempel Christina, Elsenbruch Sigrid, Lauche Romy, Ahmed Mohamed, Haller Dirk, Cramer Holger, Dobos Gustav, Koch Anna K

机构信息

Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Germany, Chair for Integrative Medicine, University of Duisburg-Essen, Buger Straße 80, 96049 Bamberg, Germany.

Integrative Gastroenterology, University of Duisburg-Essen, Evang. Kliniken-Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany.

出版信息

J Clin Med. 2020 Sep 24;9(10):3087. doi: 10.3390/jcm9103087.

Abstract

Patients with ulcerative colitis suffer from impaired health-related quality of life (HrQoL). Comprehensive lifestyle-modification might increase HrQoL and decrease disease activity. Ninety-seven patients in clinical remission with impaired HrQoL were randomly assigned to a 10 week comprehensive lifestyle-modification program (LSM; = 47; 50.28 ± 11.90 years) or control ( = 50; 45.54 ± 12.49 years) that received a single workshop of intense training in naturopathic self-help strategies. Primary outcome was HrQoL (Inflammatory Bowel Disease Questionnaire; IBDQ) at week 12. Secondary outcomes included IBDQ subscales; generic HrQoL; disease activity and microbiome. Both groups showed improvement in HrQoL from baseline to post-treatment at week 12. The IBDQ sum score showed no significant group difference ( = 0.251). If patients attended more than 50% of the training sessions, a significant group effect ( = 0.034) was evident in favor of LSM. In addition, the SF-36 mental component summary ( = 0.002) was significantly different between the groups in favor of LSM. Disease activity microbiome and adverse events did not differ. Both a single workshop and a 10-week comprehensive lifestyle-modification program can improve HrQoL in patients with ulcerative colitis in remission with no apparent effects on clinical disease activity. A treatment difference was observed when examining a subsample of patients who attended ≥ 50% of sessions.

摘要

溃疡性结肠炎患者的健康相关生活质量(HrQoL)受损。全面的生活方式改变可能会提高HrQoL并降低疾病活动度。97名临床缓解但HrQoL受损的患者被随机分配到一个为期10周的全面生活方式改变计划(LSM;n = 47;50.28±11.90岁)或对照组(n = 50;45.54±12.49岁),对照组接受了一次关于自然疗法自助策略的强化培训工作坊。主要结局是第12周时的HrQoL(炎症性肠病问卷;IBDQ)。次要结局包括IBDQ子量表;一般HrQoL;疾病活动度和微生物组。两组从基线到第12周治疗后的HrQoL均有改善。IBDQ总分无显著组间差异(P = 0.251)。如果患者参加了超过50%的培训课程,则明显有利于LSM的显著组效应(P = 0.034)明显。此外,两组间SF-36精神成分总结(P = 0.002)有显著差异,有利于LSM。疾病活动度、微生物组和不良事件无差异。单次工作坊和为期10周的全面生活方式改变计划均可改善缓解期溃疡性结肠炎患者的HrQoL,对临床疾病活动度无明显影响。在检查参加≥50%课程的患者子样本时观察到治疗差异。

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