炎症性肠病的常见心理问题及诊治进展

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摘要炎症性肠病（IBD）患者心理问题的发生率显著高于普通人群，其中最受关注的是焦虑、抑郁及慢性腹痛等。脑-肠轴的紊乱是IBD疾病活动与心理问题双向影响的重要机制。IBD患者心理状态的评估和规范化治疗日益受到重视。心理治疗是对IBD传统治疗的重要补充，不但可减轻IBD患者焦虑、抑郁及慢性腹痛等症状，还可降低IBD疾病活动度，预防不必要的治疗升级，提高患者生活质量，改变疾病的自然史。一种IBD的“生物-心理-社会”综合治疗新模式正在形成。本文对IBD常见心理问题及其与IBD疾病活动的双向影响及机制、诊断及治疗进展进行了综述。

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	许凌云1 陈思玮1 刘欢宇2 冉艳1 陈宁宁1 孙林1 陈余1 厉英超1

关键词 ：炎症性肠病, 心理问题, 脑-肠轴, 双向影响, 心理评估, 心理治疗

Abstract：The Patients with inflammatory bowel disease (IBD) have significantly higher rates of psychological issues than the general population. Anxiety, depression and chronic abdominal pain are the most notable. The disorder of brain-gut axis is the important mechanism in bi-directional interactions between IBD disease activity and psychological issues. More and more attention has been paid to the diagnostic approaches of psychological conditions and standardized psychological treatments in IBD. Psychotherapy, an important supplement to the traditional treatment of IBD, can not only reduce the symptoms of psychological issues in IBD patients, but also reduce the activity of IBD disease. Moreover it can prevent unnecessary treatment escalation and improve the quality of life of patients. It can also change the disease course. A new “bio-psycho-social” medical model of IBD is emerging. This article reviews the common psychological issues in IBD patients, the interactions between psychological issues and IBD disease activity, and the progress of diagnosis and treatment.

Key words： Inflammatory bowel disease Psychological issues Brain-gut axis Bi-directional interactions Psychological assessment Psychotherapy

基金资助:陕西省重点研发国际科技合作计划项目（2019KW-036）。

通讯作者: 厉英超（1974.10-），女，博士，主任医师，西安交通大学第一附属医院消化内科副主任，硕士生导师；研究方向：炎症性肠病的诊治。

作者简介: 许凌云（1995.8-），女，西安交通大学第一附属医院2017级内科学专业在读硕士研究生；研究方向：炎症性肠病的诊治。

引用本文:

许凌云1 陈思玮1 刘欢宇2 冉艳1 陈宁宁1 孙林1 陈余1 厉英超1. 炎症性肠病的常见心理问题及诊治进展[J]. 中国医药导报, 2020, 17(25): 49-52.
XU Lingyun1 CHEN Siwei1 LIU Huanyu2 RAN Yan1 CHEN Ningning1 SUN Lin1 CHEN Yu1 LI Yingchao1. Common psychological issues and diagnosis and treatment progress in patients with inflammatory bowel disease. 中国医药导报, 2020, 17(25): 49-52.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I25/49

[1] Regueiro M，Greer JB，Szigethy E. Etiology and Treatment of Pain and Psychosocial Issues in Patients with Inflammatory Bowel Diseases [J]. Gastroenterology，2017，152（2）：430-439.e4.
[2] Savage N. Q&A：Eva Szigethy [J]. Nature，2016，540（7634）：S113.
[3] Williet N，Sarter H，Gower-Rousseau C，et al. Patient-reported Outcomes in a French Nationwide Survey of Inflammatory Bowel Disease Patients [J]. J Crohns Colitis，2017，11（2）：165-174.
[4] Banerjee T，Gearry R. Editorial：Suicide and IBD-a Call to Action [J]. Aliment Pharmacol Ther，2019，50（1）：105-106.
[5] Gracie DJ，Williams CJ，Sood R，et al. Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome-type Symptoms in Patients with Inflammatory Bowel Disease [J]. Clin Gastroenterol Hepatol，2017，15（3）：376-384.e5.
[6] Henriksen M，Høivik ML，Jelsness-jelrgensen LP，et al. Irritable Bowel-like Symptoms in Ulcerative Colitis are as Common in Patients in Deep Remission as in Inflammation：Results from a Population-based Study [the IBSEN study] [J]. J Crohns Colitis，2018，12（4）：389-393.
[7] Gracie DJ，Guthrie EA，Hamlin PJ，et al. Bi-directionality of Brain-Gut Interactions in Patients with Inflammatory Bowel Disease [J]. Gastroenterology，2018，154（6）：1635-1646.e3.
[8] Ananthakrishnan AN，Khalili H，Pan A，et al. Association Between Depressive Symptoms and Incidence of Crohn′s Disease and Ulcerative Colitis：Results from the Nurses′Health Study [J]. Clin Gastroenterol Hepatol，2013，11（1）：57-62.
[9] Kochar B，Barnes EL，Long MD，et al. Depression is Associated with More Aggressive Inflammatory Bowel Disease [J]. Am J Gastroenterol，2017，113（1）：80-85.
[10] Alexakis C，Kumar S，Saxena S，et al. Systematic Review with Meta-analysis：The Impact of a Depressive State on Disease Course in Adult Inflammatory Bowel Disease [J]. Aliment Pharmacol Ther，2017，46（3）：225-235.
[11] Gracie DJ，Hamlin JP，Ford AC. Longitudinal Impact of IBS-type Symptoms on Disease Activity，Healthcare Utilization，Psychological Health，and Quality of Life in Inflammatory Bowel Disease [J]. Am J Gastroenterol，2018， 113（5）：702-712.
[12] Bonaz BL，Bernstein CN. Brain-Gut Interactions in Inflammatory Bowel Disease [J]. Gastroenterology，2013， 144（1）：36-49.
[13] Mohajeri MH，La Fata G，Steinert RE，et al. Relationship Between the Gut Microbiome and Brain Function [J]. Nutr Rev，2018，76（7）：481-496.
[14] Mawdsley JE，Rampton DS. Psychological Stress in IBD：New Insights into Pathogenic and Therapeutic Implications [J]. Gut，2005，54（10）：1481-1491.
[15] Gracie DJ，Hamlin PJ，Ford AC. The Influence of the Brain-gut Axis in Inflammatory Bowel Disease and Possible Implications for Treatment [J]. Lancet Gastroenterol Hepatol，2019，4（8）：632-642.
[16] Kochar B，Martin CF，Kappelman MD，et al. Evaluation of Gastrointestinal Patient Reported Outcomes Measurement Information System（GI-PROMIS）Symptom Scales in Subjects with Inflammatory Bowel Diseases [J]. Am J Gastroenterol，2018，113（1）：72-79.
[17] Klag T，Mazurak N，Fantasia L，et al. High Demand for Psychotherapy in Patients with Inflammatory Bowel Disease [J]. Inflamm Bowel Dis，2017，23（10）：1796-1802.
[18] Kristensen MS，Kjærulff TM，Ersbøll AK，et al. The Influence of Antidepressants on the Disease Course Among Patients with Crohn′s Disease and Ulcerative Colitis—A Danish Nationwide Register-Based Cohort Study [J]. Inflamm Bowel Dis，2019，25（5）：886-893.
[19] Macer BJ，Prady SL，Mikocka-walus A. Antidepressants in Inflammatory Bowel Disease：A Systematic Review [J]. Inflamm Bowel Dis，2017，23（4）：534-550.
[20] Peters SL，Muir JG，Gibson PR. Review Article：Gut-directed Hypnotherapy in The Management of Irritable Bowel Syndrome and Inflammatory Bowel Disease [J]. Aliment Pharmacol Ther，2015，41（11）：1104-1115.
[21] Neilson K，Ftanou M，Monshat K，et al. A Controlled Study of a Group Mindfulness Intervention for Individuals Living with Inflammatory Bowel Disease [J]. Inflamm Bowel Dis，2016，22（3）：694-701.
[22] Stevens BW，Borren NZ，Velonias G，et al. Vedolizumab Therapy is Associated with an Improvement in Sleep Quality and Mood in Inflammatory Bowel Diseases [J]. Dig Dis Sci，2017，62（1）：197-206.
[23] Bonaz B，Sinniger V，Hoffmann D，et al. Chronic Vagus Nerve Stimulation in Crohn′s Disease：a 6-month Follow-up Pilot Study [J]. Neurogastroenterol Motil，2016， 28（6）：948-953.
[24] Neeb L，Bayer A，Bayer KE，et al. Transcranial Direct Current Stimulation in Inflammatory Bowel Disease Patients Modifies Resting-state Functional Connectivity：A RCT [J]. Brain Stimul，2019，12（4）：978-980.
[25] Kamp KJ，West P，Holmstrom A，et al. Systematic Review of Social Support on Psychological Symptoms and Self-management Behaviors Among Adults with Inflammatory Bowel Disease [J]. J Nurs Scholarsh，2019，51（4）：380-389.