Psychophysiological Effects of Occupational Therapy in Patients with Irritable Bowel Syndrome

肠易激综合征(IBS)的症状通常会因压力而加重，这会改变结肠运动和内脏知觉。我们报道了通过被动腹肌拉伸来改善IBS病理生理学的可能性，如嗜铬粒素A(CgA)，一种交感/肾上腺髓质系统活动的生化指标所表明的那样。虽然患者在锻炼和日常活动管理方面的干预能够通过更健康的生活方式行为改善IBS症状的程度尚不清楚。本研究的目的是确定对非IBS患者的干预对短期和长期结果的影响，以及体育锻炼与症状之间的关系。本研究采用病例对照研究方法，将30例轻、中度IBS患者随机分为运动干预组(n=15)和等待对照组(n=15)。四周的干预由自我记录、腹肌伸展、骨盆锻炼和15min工作组成。干预前后分别进行症状受限日常生活能力、心理状态、CGA、心率变异性和局部脑氧合血红蛋白变化等检测。使用Spearman等级相关来评估心理生理数据和症状评分之间的关联。Wilcoxon等级和检验将分数的变化与它们的基准值进行比较。干预后患者的日常生活能力和心理状态均有改善趋势。为期四周的干预对IBS患者的生理变量和一些神经因素有即时的有益影响。本研究结果可供干预、教育及体质健康政策参考。

Symptoms of Irritable bowel syndrome (IBS) are often aggravated by stress, which alters colonic motility and visceral perception. We reported the possibility of improving IBS pathophysiology by passive abdominal muscle stretching as indicated by chromogranin A (CgA), a biochemical index of the activity of the sympathetic/adrenomedullary system. Although the degree to which patient intervention in the areas of exercise, and management of daily activity can improve symptoms of IBS through healthier lifestyle behaviors is unknown. The aim of this study was to determine the effects of intervention to non-patient with IBS on the short and long term outcomes, and the association between physical exercise and symptoms. The present case controlled study was conducted on 30 adult subjects with mild or moderate symptom of IBS who were allocated randomly to either the exercise (intervention) group (n=15) or the wait-listed control group (n=15). Four-week intervention consisted of components : self record, stretch of abdominal muscle, physical exercise of pelvis, and 15 min working. Measurements (symptom-limited daily life performance, psychological status, CgA, heart rate variability and regional cerebral oxy-hemoglobin change) were performed before and after intervention. Spearman rank correlations were used to assess the association between psycho-physiological data and symptom scores. Wilcoxon rank sum tests compared changes in scores versus their baseline values. After the intervention, tendency of improvements were found in symptom-limited performance of daily life and psychological status. The four-week intervention had immediate beneficial effects on physiological variables and some neurological factors in patients with IBS. The findings of this study could be used as a reference for intervention, education, and physical health policies.