CAJ | 학술논문

目的探讨重归因-认知-药物整体治疗模式在治疗肠易激综合征中的临床效果.方法 125例肠易激综合征(IBS-D)患者分为A、B2组.A组为非重归因-认知-药物模式治疗组,62例,口服帕罗西汀10mg/d,1周后加至20mg/d.不用其他药物,不做心理治疗.B组63例,采用重归因-认知-药物模式(RCPM)治疗.每周会谈1次,第1次会谈≥30min,以后每次≥15min.共6次.第1次会谈后给予帕罗西汀10mg/d,1周后加至20mg/d.结果 4周末A组29例腹痛明显减轻,28例便次减少,B组48例腹痛明显减轻,42例便次减少;12周末A组36例腹痛明显减轻,30例便次减少,B组54例腹痛明显减轻,45例便次减少.2组比较差异有统计学意义(P＜0.05).A组4周末12例停用帕罗西汀,12周末14例停用帕罗西汀;B组4周末3例停用帕罗西汀,12周末5例停用帕罗西汀;2组比较差异有统计学意义(P＜0.05).结论 RCPM能有效减轻肠易激综合征的症状,比单用帕罗西汀效果更明显RCPM能明显提高IBS患者对抗抑郁药物的依从性.
목적 탐토중귀인-인지-약물정체치료모식재치료장역격종합정중적림상효과.방법 125례장역격종합정(IBS-D)환자분위A、B2조.A조위비중귀인-인지-약물모식치료조,62례,구복파라서정10mg/d,1주후가지20mg/d.불용기타약물,불주심리치료.B조63례,채용중귀인-인지-약물모식(RCPM)치료.매주회담1차,제1차회담≥30min,이후매차≥15min.공6차.제1차회담후급여파라서정10mg/d,1주후가지20mg/d.결과 4주말A조29례복통명현감경,28례편차감소,B조48례복통명현감경,42례편차감소;12주말A조36례복통명현감경,30례편차감소,B조54례복통명현감경,45례편차감소.2조비교차이유통계학의의(P＜0.05).A조4주말12례정용파라서정,12주말14례정용파라서정;B조4주말3례정용파라서정,12주말5례정용파라서정;2조비교차이유통계학의의(P＜0.05).결론 RCPM능유효감경장역격종합정적증상,비단용파라서정효과경명현RCPM능명현제고IBS환자대항억욱약물적의종성.
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.