Koch Anna K, Schöls Margarita, Haller Heidemarie, Anheyer Dennis, Cinar Zehra, Eilert Ronja, Kofink Kerstin, Engler Harald, Elsenbruch Sigrid, Cramer Holger, Dobos Gustav, Langhorst Jost
Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany.
Department of Internal and Integrative Medicine, Klinikum Bamberg, Sozialstiftung Bamberg, 96049 Bamberg, Germany.
J Clin Med. 2021 Oct 29;10(21):5070. doi: 10.3390/jcm10215070.
The present study presents long-term results of stress-related outcomes of a prospective RCT that evaluated effects of a ten-week comprehensive lifestyle-modification program (LSM) in patients with inactive ulcerative colitis (UC). In addition, exploratory results of a sub-study applying a laboratory stress protocol (Trier Social Stress Test; TSST) conducted within the RCT are reported.
Ninety-seven patients with inactive UC were randomized to LSM ( = 47; 50.28 ± 11.90 years; 72.3% female) or self-care ( = 50; 45.54 ± 12.49 years; 70% female). Patients' perceived stress, anxiety, flourishing and depression were assessed at week 0, 12, 24 and 48. After the respective intervention, 16 female patients (LSM: = 8; 44.6 ± 14.3 years; Self-care: = 8; 49.25 ± 4.30 years) additionally underwent the TSST. State anxiety, blood pressure, pulse, complete blood counts, adrenocorticotropic hormone (ACTH), cortisol, adrenalin and noradrenalin were measured at (-15 min), (+10 min), (+20 min) and (+55 min). Statistical significance was set at < 0.05; for the exploratory sub-study using the TSST, -values < 0.10 were considered significant.
Patients' perceived stress declined significantly after the LSM ( < 0.001) compared with control. This lasted until week 24 ( = 0.023) but did not persist until week 48 ( = 0.060). After 48 weeks, patients' flourishing was significantly increased compared with control ( = 0.006). In response to the TSST, significant group differences were evident for pulse ( = 0.015), adrenaline ( = 0.037) and anxiety ( = 0.066). After 55 min, group differences were found for ACTH ( = 0.067) and systolic blood pressure ( = 0.050).
LSM has a medium-term positive effect on perceived stress. First indications show that it is promising to investigate these effects further under laboratory conditions. It is also desirable to find out how the effects of LSM can be maintained in the long term.
本研究展示了一项前瞻性随机对照试验（RCT）中与压力相关结局的长期结果，该试验评估了为期十周的综合生活方式改善计划（LSM）对非活动期溃疡性结肠炎（UC）患者的影响。此外，还报告了在该RCT中应用实验室压力方案（特里尔社会压力测试；TSST）的一项子研究的探索性结果。
97例非活动期UC患者被随机分为LSM组（n = 47；年龄50.28±11.90岁；72.3%为女性）或自我护理组（n = 50；年龄45.54±12.49岁；70%为女性）。在第0、12、24和48周评估患者的感知压力、焦虑、蓬勃状态和抑郁情况。在各自干预后，16例女性患者（LSM组：n = 8；年龄44.6±14.3岁；自我护理组：n = 8；年龄49.25±4.30岁）额外接受了TSST。在-15分钟、+10分钟、+20分钟和+55分钟测量状态焦虑、血压、脉搏、全血细胞计数、促肾上腺皮质激素（ACTH）、皮质醇、肾上腺素和去甲肾上腺素。设定统计学显著性为P < 0.05；对于使用TSST的探索性子研究，P值< 0.10被认为具有显著性。
与对照组相比，LSM组患者的感知压力在干预后显著下降（P < 0.001）。这种情况持续到第24周（P = 0.023），但在第48周时不再持续（P = 0.060）。48周后，与对照组相比，患者的蓬勃状态显著增加（P = 0.006）。在对TSST的反应中，脉搏（P = 0.015）、肾上腺素（P = 0.037）和焦虑（P = 0.066）存在显著的组间差异。55分钟后，ACTH（P = 0.067）和收缩压（P = 0.050）存在组间差异。
LSM对感知压力有中期积极影响。初步迹象表明，在实验室条件下进一步研究这些影响很有前景。还需要弄清楚如何长期维持LSM的效果。
