van Dulmen A M, Fennis J F, Bleijenberg G
Department of General Practice and Social Medicine, University of Nijmegen, The Netherlands.
Psychosom Med. 1996 Sep-Oct;58(5):508-14. doi: 10.1097/00006842-199609000-00013.
Little is known about the effectiveness of cognitive behavioral treatment for patients with irritable bowel syndrome on a group basis. Previous studies have used only small samples, and studies with long term follow-up are lacking. The arm of the present study was to investigate: a) the effectiveness of a cognitive-behavioral group treatment compared with a waiting list control condition in alleviating abdominal complaints and b) the long term effectiveness of cognitive-behavioral group treatment. In study 1, we performed a controlled study with 25 patients in the group treatment condition and 20 patients in the waiting list control condition. Treatment consisted of eight 2-hour group sessions over a period of 3 months. In study 2, all patients were treated and followed up for an average of 2.25 years (range 6 months-4 years) after the completion of the group treatment. The abdominal complaints of the patients who underwent treatment were found to improve significantly more than the complaints of the patients awaiting treatment. Moreover, in agreement with the purpose of the therapy, the number of successful coping strategies was found to increase more and patients' avoidance behavior was found to decrease more in the treatment group than in the waiting list control group. The positive changes appeared to persist during follow-up. Cognitive-behavioral group treatment is effective in alleviating irritable bowel syndrome, in stimulating coping strategies, and in reducing avoidance behavior. At long term follow-up, the abdominal complaints, the number of successful coping strategies, and the avoidance behavior were still improved compared with the pretreatment assessment.
关于以团体形式对肠易激综合征患者进行认知行为治疗的有效性，目前所知甚少。以往的研究仅使用了小样本，且缺乏长期随访的研究。本研究的目的是调查：a）与等待名单对照条件相比，认知行为团体治疗在减轻腹部不适方面的有效性；b）认知行为团体治疗的长期有效性。在研究1中，我们进行了一项对照研究，25名患者接受团体治疗，20名患者作为等待名单对照。治疗包括在3个月内进行8次每次2小时的团体治疗。在研究2中，所有患者在团体治疗结束后平均接受了2.25年（范围为6个月至4年）的随访。结果发现，接受治疗的患者的腹部不适改善程度明显高于等待治疗的患者。此外，与治疗目的一致，发现治疗组中成功应对策略的数量增加得更多，患者的回避行为减少得更多，相比等待名单对照组。这些积极变化在随访期间似乎持续存在。认知行为团体治疗在减轻肠易激综合征、促进应对策略以及减少回避行为方面是有效的。在长期随访中，与治疗前评估相比，腹部不适、成功应对策略的数量以及回避行为仍有所改善。
