一项数字肠道导向催眠治疗与肌肉松弛治疗肠易激综合征的随机平行组研究。
A Randomized Parallel-group Study of Digital Gut-directed Hypnotherapy vs Muscle Relaxation for Irritable Bowel Syndrome.
机构信息
New York Gastroenterology Associates, New York, New York.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, California.
出版信息
Clin Gastroenterol Hepatol. 2023 Nov;21(12):3152-3159.e2. doi: 10.1016/j.cgh.2023.06.015. Epub 2023 Jun 28.
BACKGROUND & AIMS: Gut-directed hypnotherapy (GDH) is effective for treating irritable bowel syndrome (IBS), but access limits its widespread use. We report the first randomized controlled trial comparing the safety and efficacy of a self-administered, digital GDH treatment program with that of digital muscle relaxation (MR) in adults with IBS.
METHODS
After a 4-week run-in period, patients were randomized to 12 weeks of treatment with digital GDH (Regulora), or digital MR accessed via a mobile app on a smartphone or tablet. The primary endpoint was abdominal pain response, defined as ≥30% reduction from baseline in average daily abdominal pain intensity in the 4 weeks following treatment. Key secondary outcomes included mean change from baseline in abdominal pain, stool consistency, and stool frequency.
RESULTS
Of 378 randomized patients, 362 were treated and included in the efficacy analysis. A similar proportion of the GDH (30.4%) and MR (27.1%) groups met the primary endpoint, with no significant difference between the groups (P = .5352). Significantly more patients treated with GDH than MR were abdominal pain responders during the last 4 weeks of treatment (30.9% vs 21.5%; P = .0232) and over the entire treatment period (29.3% vs 18.8%; P = .0254). Improvements in abdominal pain, stool consistency, and stool frequency were consistent across IBS subtypes. No patients experienced serious adverse events or adverse events leading to study discontinuation.
CONCLUSIONS
Treatment with a digital GDH program led to an improvement in abdominal pain and stool symptoms in patients with IBS, supporting a role for this intervention as part of integrated care for IBS.
CLINICALTRIALS
gov identifier NCT04133519.
背景与目的
肠道导向催眠疗法(GDH)对治疗肠易激综合征(IBS)有效,但由于获取途径的限制,其广泛应用受到限制。我们报告了首例比较自我管理的数字 GDH 治疗方案与数字肌肉放松(MR)治疗成人 IBS 的安全性和疗效的随机对照试验。
方法
经过 4 周的导入期后,患者被随机分为 12 周的数字 GDH(Regulora)治疗组或通过智能手机或平板电脑上的移动应用程序获取的数字 MR 治疗组。主要终点是腹痛缓解,定义为治疗后 4 周内平均每日腹痛强度较基线降低≥30%。主要次要结局包括腹痛、粪便稠度和排便频率的平均变化。
结果
在 378 名随机患者中,有 362 名患者接受了治疗并纳入疗效分析。GDH 组(30.4%)和 MR 组(27.1%)达到主要终点的比例相似,两组间无显著差异(P=.5352)。在治疗的最后 4 周,接受 GDH 治疗的患者中腹痛缓解者比例显著高于接受 MR 治疗的患者(30.9%比 21.5%;P=.0232),在整个治疗期间也是如此(29.3%比 18.8%;P=.0254)。腹痛、粪便稠度和排便频率的改善在 IBS 各亚型中一致。没有患者发生严重不良事件或导致研究中止的不良事件。
结论
数字 GDH 治疗方案可改善 IBS 患者的腹痛和粪便症状,支持该干预措施作为 IBS 综合治疗的一部分。
临床试验
gov 标识符 NCT04133519。