ABSTRACT
Objective To investigate the efficacy of combination of reattribution cognitive psychotherapy and low-dose antidepressants in the treatment of ulcerative colitis (UC) complicated with functional symptoms , and to explore the psychosomatic digestive disease pattern that incorporated psychosocial variables into clinical thinking and practice .Methods From March 2016 to April 2017 ,sixty patients with UC who met the admission criteria were randomly divided into control group and observation group with 30 patients in each group .Both groups were treated with oral mesalazine ,and the observation group was further treated with reattribution cognitive psychotherapy and antidepressants . Clinical symptoms ,self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the efficacy at the time of enrollment and four weeks after treatment in both groups .Chi square test or t test was performed for statistical analysis .Results Among the 60 patients ,47 (78 .3％ ) met four syndromes of diagnostic criteria for phychosomatic research , and there was no statistically significant difference in the case number of each syndrome between the two groups (P> 0 .05) .After four weeks treatment ,the total effective rates of observation group and control group was 93 .3％ (28/30 ) and 53 .3％ (16/30) ,respectively ,and the difference was statistically significant (χ2 = 22 .667 ,P< 0 .05) . Before and four weeks after treatment , the SAS scores of observation group were 54 .50 ± 6 .70 and 41 .07 ± 3 .72 ,respectively ,and the difference was statistically significant (t=9 .595 ,P= 0 .005) .The SAS scores of control group were 54 .30 ± 6 .06 and 51 .90 ± 7 .92 ,respectively ,and the difference was not statistically significant (P=0 .195) .Before and four weeks after treatment ,the SDS scores of observation group were 50 .63 ± 6 .29 and 34 .40 ± 4 .58 ,respectively ,and the difference was statistically significant (t=11 .426 ,P=0 .025) .The SDS scores of control group were 50 .03 ± 6 .02 and 43 .47 ± 6 .81 ,respectively , and the difference was not statistically significant ( P= 0 .307 ) . Conclusions Psychosomatic model can significantly improve the functional symptoms complicated with UC .It is meaningful to incorporate psychosocial variables into clinical thinking and practice in psychosomatic digestive disease pattern .
ABSTRACT
Objective To investigate clinical effect of reattribution-cognitive-pharmacy model (RCPM) in the treatment for irritable bowel syndrome(IBS). Methods 125 subjects with diarrhea predominant irritable bowel syndrome (IBS-D) were divided into two groups randomly. 62 patients in group A were treated with 10 ～ 20 mg of paroxetine without any other medication or psychological interview and 63 patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 ～ 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency ,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain ,and 42 reported a reduction in stool frequency ,and 3 patients stopped taking paroxetine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain ,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B,54 cases reported a reduction in abdominal pain,and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.