Biopsychosocial model of irritable bowel syndrome.
Biopsychosocial model of irritable bowel syndrome.
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DOI：
10.5056/jnm.2011.17.2.131
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发表时间：
2011-04
影响因子：
3.4
通讯作者：
Drossman DA
中科院分区：
文献类型：
--
作者：
Tanaka Y;Kanazawa M;Fukudo S;Drossman DA
肠易激综合征（IBS）是一种常见的慢性疾病，见于胃肠病学和初级保健实践。其特征是反复发作的腹痛或与肠功能紊乱相关的不适。它是一种具有不同治疗方法的异质性疾病，在这方面，医生有时会努力寻找管理IBS患者的最佳方法。这种疾病导致高昂的医疗保健费用，并降低了与健康有关的生活质量。IBS属于功能性胃肠道疾病，并且是由中枢和肠神经系统相互作用的失调引起的。心理社会因素与其肠道生理、相关认知、症状表现和患病行为密切相关。因此，重要的是医生要认识到IBS患者的社会心理问题，并建立良好的医患关系，以优化治疗。这篇综述着重于通过生物心理社会模型研究与IBS相关的心理和生理因素之间的相互作用。在这篇文章中，我们描述了（1）在早期生活中看到的易感心理特征;（2）与生活压力相关的心理因素，症状表现及其相关的应对模式;（3）肠道病理生理学，重点是运动障碍，内脏高敏感性和脑-肠道相互作用;最后（4）临床结果和有效的治疗方法，包括心理治疗方法。
Irritable bowel syndrome (IBS) is a common chronic disorder seen in gastroenterology and primary care practice. It is characterized by recurrent abdominal pain or discomfort associated with disturbed bowel function. It is a heterogeneous disorder with varying treatments, and in this regard physicians sometimes struggle with finding the optimal approach to management of patients with IBS. This disorder induces high health care costs and variably reduces health-related quality of life. IBS is in the class of functional gastrointestinal disorders, and results from dysregulation of central and enteric nervous system interactions. Psychosocial factors are closely related to their gut physiology, associated cognitions, symptom manifestations and illness behavior. Therefore, it is important for the physician to recognize the psychosocial issues of patients with IBS and in addition to build a good patient-physician relationship in order to optimize treatment. This review focuses on the interaction between psychological and physiological factors associated with IBS by using a biopsychosocial model. In this article, we describe (1) the predisposing psychological features seen in early life; (2) the psychological factors associated with life stress, the symptom presentation, and their associated coping patterns; (3) gut pathophysiology with emphasis on disturbances in motility, visceral hypersensitivity and brain-gut interactions; and finally (4) the clinical outcomes and effective treatments including psychotherapeutic methods.
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影响因子：
29.4
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