Guthrie E, Creed F, Dawson D, Tomenson B
North West Regional Health Authority, Manchester.
Br J Psychiatry. 1993 Sep;163:315-21. doi: 10.1192/bjp.163.3.315.
Patients with chronic, refractory irritable bowel syndrome (n = 102) were entered into a randomised controlled trial of psychotherapy versus supportive listening. Independent physical and psychological assessments were carried out at the beginning and end of the 12-week trial. For women, psychotherapy was found to be superior to supportive listening, in terms of an improvement in both physical and psychological symptoms. There was a similar trend for men, but this did not reach significance. Following completion of the trial, patients in the control group were offered psychotherapy; 33 accepted and following treatment experienced a marked improvement in their symptoms; ten declined. At follow-up one year later, those patients who had received psychotherapy remained well, patients who had dropped out of the trial were unwell with severe symptoms, and most of the controls who declined psychotherapy had relapsed. This study shows that psychotherapy is feasible and effective in the majority of irritable bowel syndrome patients with chronic symptoms unresponsive to medical treatment.
102例患有慢性难治性肠易激综合征的患者参与了一项心理治疗与支持性倾听的随机对照试验。在为期12周的试验开始和结束时进行了独立的身体和心理评估。对于女性而言，就身体和心理症状的改善而言，发现心理治疗优于支持性倾听。男性也有类似趋势，但未达到显著水平。试验结束后，对照组的患者可接受心理治疗；33人接受了治疗，治疗后症状明显改善；10人拒绝。在一年后的随访中，接受心理治疗的患者状况良好，退出试验的患者症状严重且身体不适，大多数拒绝心理治疗的对照组患者病情复发。这项研究表明，心理治疗对于大多数患有慢性症状且药物治疗无效的肠易激综合征患者是可行且有效的。
