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抗抑郁药可以治疗炎症性肠病?Nature综述子刊万字详解!
这是《肠道产业》第 224 篇文章
编者按:
之前,我们特别报道了利用肠导向催眠法治疗肠易激综合症(IBS):肠道会说话?好好和它沟通或可治疗 IBS?诺奖大佬也在攻关!
今天,我们关注另一种治疗手段:抗抑郁药物。抗抑郁药物通常用于治疗炎症性肠病(IBD)的焦虑和抑郁症状。而最近研究表明,IBD 活动与个人情绪状态之间存在联系,这增加了抗抑郁药可能会改变 IBD 病程的可能性。
抗抑郁药物与 IBD 究竟存在怎样的互作机制?我们有可能用抗抑郁药物治疗 IBD 吗?
今天,我们特别编译发表在Nature Reviews Gastroenterology & Hepatology 上关于如何利用抗抑郁药物治疗 IBD 的综述。希望该文为相关人士带来一些帮助与启发。
以下是全文编译:
摘要
Box :心理疗法应用于胃肠病学
心理疗法,或谈话疗法,在此过程中,患者与医师定期见面讨论病人生活的各个方面,通过谈话提升患者的幸福感。虽然心理治疗通常都涉及到信任这一交流共同元素,但不同类型的心理治疗具有不同的理论、应用手段,以及能够改变患者行为、习惯和潜在驱动因素的假设机制。认知行为疗法(CBT)、心理动力疗法、肠导向催眠疗法和其他心理疗法已被广泛应用于胃肠病学11。
一项荟萃分析汇总了 IBS 中的心理疗法随机对照实验。IBS 是一种 DGBI(之前被称为功能性胃肠疾病),该实验证实了认知行为治疗、催眠治疗、多重心理治疗和动态心理治疗在改善 IBS 症状方面的疗效91。
另一项荟萃分析显示,各种心理疗法(认知行为疗法、催眠疗法、精神动力疗法和放松疗法)的效果相当,但是认知行为疗法对患者日常生活的改善最大151。
在 DGBI 中,心理治疗常被用作一种辅助治疗,与抗抑郁药物相结合,治疗患有严重胃肠道症或共病患者13,152。
IBD 是一种常伴随 DGBI 的胃肠道疾病129,心理治疗疗效的证据不如 DGBI 的有力,有效性数据仅限于短期改善生活质量和抑郁指数,并没有改善疾病活动或治疗后的长期影响153。
关于胃肠疾病心理治疗的未来发展,特别是依赖于弹性、乐观和自我调节的积极心理学解决方案,已经在之前的文章全面讨论过12。
脑-肠失调
抗抑郁药物作用机制
DGBI治疗中的抗抑郁药物
抗抑郁药物在IBD中的作用
抗抑郁药在IBD中的潜在作用
结论
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