Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Center for Neurointestinal Health, Massachusetts General Hospital, Boston, Massachusetts, USA.
Neurogastroenterol Motil. 2022 Nov;34(11):e14429. doi: 10.1111/nmo.14429. Epub 2022 Jul 14.
Satisfaction with current treatment options for irritable bowel syndrome with constipation (IBS-C) is low, with many patients turning to complementary treatments. Tai Chi is a mind-body medicine practice with proven efficacy in other functional disorders. As a proof-of-concept, we tested the feasibility and preliminary clinical outcomes associated with a Tai Chi program designed for IBS-C.
A total of 27 IBS-C patients participated in a single-arm trial of 8 sessions of Tai Chi delivered weekly over 7 weeks via live videoconferencing in group format. Clinical improvement was assessed via change in IBS Symptom Severity Score (IBS-SSS) from baseline to 4 weeks posttreatment (week 11) with secondary outcomes exploring symptom ratings, IBS-related quality of life (IBS-QOL), GI-specific anxiety, abdominal distention, and psychological factors.
Despite substantial dropout (n = 7; 26%), the treatment protocol had moderate to excellent feasibility for other criteria. Treatment satisfaction was excellent. Exit interviews confirmed high satisfaction with the program among completers, but a high burden of data collection was noted. One participant experienced an adverse event (mild, exacerbation of sciatica). There was a significant improvement in intra-individual IBS-SSS between baseline and posttreatment (average change -66.5, 95% CI -118.6 to -14.3, p = 0.01). Secondary outcomes were notable for improvements in other IBS symptom scoring measures, IBS-QOL, measured abdominal diameter, and leg strength.
Our data provide preliminary evidence of the feasibility of a Tai Chi intervention for IBS-C, show promise for improving outcomes, and identify more streamlined data collection as an area for further program improvement.
对于便秘型肠易激综合征(IBS-C)患者而言,目前的治疗选择满意度较低,许多患者转而采用补充疗法。太极是一种身心医学实践,已被证明在其他功能性疾病中有效。作为概念验证,我们测试了专为 IBS-C 设计的太极方案相关的可行性和初步临床结果。
共 27 名 IBS-C 患者参加了一项单臂试验,该试验在 7 周内每周通过现场视频会议以小组形式进行 8 次太极课程。通过 IBS 症状严重程度评分(IBS-SSS)从基线到治疗后 4 周(第 11 周)的变化来评估临床改善,次要结果则是探索症状评分、IBS 相关生活质量(IBS-QOL)、胃肠道特异性焦虑、腹胀和心理因素。
尽管有大量脱落(n=7;26%),但对于其他标准,治疗方案具有中等到极好的可行性。治疗满意度非常高。退出访谈证实,完成者对该方案非常满意,但也注意到数据收集负担很重。一名参与者发生了不良事件(轻度,坐骨神经痛加重)。IBS-SSS 在个体内的基线和治疗后之间有显著改善(平均变化-66.5,95%CI-118.6 至-14.3,p=0.01)。次要结果是其他 IBS 症状评分指标、IBS-QOL、测量的腹围和腿部力量的改善。
我们的数据提供了太极干预 IBS-C 的可行性的初步证据,表明其有改善结果的潜力,并确定了更精简的数据收集作为进一步改善计划的领域。