肠易激综合征的心理治疗

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(收稿日期:2008208205)

肠易激综合征的心理治疗

朱良如,侯晓华　(华中科技大学同济医学院附属协和医院消化内科,武汉　430022)

关键词:　肠易激综合征;　心理治疗

[中图分类号]R57414　[文献标志码]A　[文章编号]10052541X(2008)052270203

精神心理因素在肠易激综合征(irritable bowel syndr o me,I B S)发病中的重要作用日益受到临床医师的重视。据统计40%～50%的I B S患者有心理障碍表现,其中以焦虑、抑郁、癔病多见。这些情绪障碍开始出自于病人对疾病的不理解和担忧,而这种担忧和焦虑又加重了肠道的症状,形成了恶性循环,约80% I B S患者病情发作和加重与精神心理因素有关[1]。

I B S难以治愈,尚无法实现临床症状的完全消失。临床治疗多集中于给予促动力药、解痉药、通便药、调整肠功能药及杀菌制剂药,而忽视了对精神心理因素的关注,治疗效果常常并不理想,致使病程迁延,反过来又加重了病人的情绪障碍,甚至失去了对治疗的信心,因此重视对I B S患者的心理治疗具有重大意义[2]。心理治疗的目标不是治愈疾病,而是消除病人对疾病的恐惧心理,树立战胜疾病的信心;减少病人心理情感应激的频率和强度;缓解临床症状,减少症状发作的频率和严重程度,提高其生活质量;减少病人反复就诊的次数,减轻社会的医疗资源和经济压力[3]。