Cognitive Behavior Therapy For The Treatment Of Patients With IBS

Objective: Irritable bowel syndrome (IBS) has been defined as psychosomatic illness by many domestic scholars, and has a high morbidity .It has been influencing the quality of life of patients with IBS at different degree. The etiology and pathogenesis of IBS has not completely understood so far, the treatment has more limitations. Reported at home and abroad in recent years/routine therapy psychological treatment can obtain good curative effect, but most of them are the joint antidepressant or resistance to anxiety drugs for treatment. This study used cognitive behavioral therapy in combination with drugs, and set the pure psychological treatment group to detect the degree of symptom reliefs for patients with IBS by using non-drug therapy.Methods: Divided the296 cases of IBS patients which Meet the inclusion criteria into four groups using random grouping principle :Blank group (69) were not giving any intervention measures, The drug therapy group (70) according to select the different drugs therapy, psychological treatment group (78 )take cognitive therapy and behavior intervention methods, psychotherapy joint drug group (79 ) in addition to conventional medicine outer adopted cognitive therapy and behavior intervention methods; All patients are involved in assessing about IBS symptom score and Hamilton depression rating scale (HAMD, 17), Hamilton anxiety scale (HAMA,14) test. and IBS - QOL scale assess. For every two weeks all patients follow-up time to evaluate the clinical symptom scores and depression and anxiety scale And evaluate the quality of life questionnaire at the end of the course of treatment(12week) .Results : In addition to the control group, the other three therapies improved patient symptoms in different degree, the overall efficacy to psychotherapy joint drug group is the best. Drug therapy treatment group total effectiveness reached 91 %, (including healed in 12 cases, powerfully 25 cases, improving 27 cases, invalid 6 cases); Psychological treatment group total effectiveness of 89%, (including healed 8 cases, powerfully 20 cases, improving 42 cases, invalid 8 cases); Psychotherapy joint drug treatment for total effectiveness 94%, 17 cases, recovery (one of them, in 44 patients got improved 14 cases, invalid 4 cases). Through the IBS - QOL quality assessment, drug group survival, psychological group, drug therapy plus psychotherapy IBS patients with symptoms of the lower, the whole spirit index of state better. If take the HAMD > 14 points, HAMA >17 points standard to divided into depression or anxiety symptoms .296 cases IBS patients with different degrees of 205 patients with depression/anxiety emotions.205 patients with IBS have 89 cases exist depressive symptoms, 74 cases exist depression and anxiety symptoms, 42 patients existent anxiety symptoms. Upon completion of treatment, follow-up patients, psychological treatment group and psychological therapy combined treatment group cases in treatment (4 weekend, six weekend, 8 weekend and 12 weekend ) Hamilton depression and anxiety rating scale down a drug treatment group and control group is remarkable. A statistically significant (P < 0.05).at the 12 week for life quality evaluation, and all the other outside except picky index all have improved, IBS - QOL integral significantly higher than the baseline.Conclusion: Drug treatment, psychological treatment, psychological therapy joint drug therapy can improve the clinical symptoms of irritable bowel syndrome and improve the quality of life of patients.in different degrees .Among them, the pure psychotherapy (this research is cognitive behavioral therapy) was less than the drug group in change clinical symptoms of IBS patients, This shows that due to the pathogenesis of IBS is not clear, and influenced by many factors, so a simple psychological treatment is able to alleviate clinical symptoms in patients with IBS, but it cannot replace the role of drug therapy, .Clinically, psychological therapy combined with drug therapy has been widely confirmed by the way, it is worth promoting In addition, In the course of the study we found the effect-acting period is late for psychotherapy in improved clinical symptoms After 10 weeks follow-up, we found that there has the tendency of continuous improvement on the clinical symptoms for patients with IBS symptoms. And the recurrence rate is lower than drug group and group psychotherapy combined with drug treatment .That cognitive behavior therapy on relief of symptoms in IBS role worthy of further exploration...