대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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심신요법이 과민성 장증후군 환자에 미치는 효과에 대한 메타분석

A Meta-Analysis on the Effects of Mind-Body Therapy on Patients with Irritable Bowel Syndrome

  • 투고 : 2019.10.22
  • 심사 : 2020.03.23
  • 발행 : 2020.06.30
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초록

Purpose: Previous randomized controlled trials (RCT) found that mind-body therapy can improve the health outcomes of patients with irritable bowel syndrome (IBS). The purpose of this meta-analysis was to identify the combined effects of mind-body therapy on patients' IBS symptoms, quality of life, anxiety, and depression. Methods: A systematic literature search was conducted using various databases such as PubMed, EMBASE, CINAHL CENTRAL, DBpia, RISS, and KISS. The primary outcome variables were IBS symptoms and quality of life; the secondary outcome variables were anxiety and depression. Comprehensive Meta-Analysis version 3.0 was used to analyze the extracted data. The effect size was calculated using standardized mean difference (SMD) and 95% confidence interval (CI). Results: Eleven final RCTs were used for this meta-analysis. Mind-body therapy was found to have a significant effect on the IBS patients' symptoms (SMD, -0.63; 95% CI, -0.77 to -0.48), quality of life (SMD, 1.03; 95% CI, 0.40 to 1.66), anxiety (SMD, -0.28; 95% CI, -0.47 to -0.09), and depression (SMD, -0.31; 95% CI, -0.06 to -0.12). Conclusion: This meta-analysis reveals that mind-body therapy significantly improves IBS patients' symptoms, quality of life, anxiety, and depression. The results suggest that, in the future, appropriate mind-body therapy should be applied to Koreans suffering from IBS. Moreover, the therapy's long-term effects should be assessed.

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참고문헌

  1. Buckley MM, O'Mahony SM, O'Malley D. Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome. World Journal of Gastroenterology. 2014;20(27):8846-8858. https://doi.org/10.3748/wjg.v20.i27.8846
  2. American College of Gastroenterology Task Force on Irritable Bowel Syndrome, Brandt LJ, Chey WD, Foxx-Orenstein AE, Schiller LR, Schoenfeld PS, et al. An evidence-based position statement on the management of irritable bowel syndrome. The American Journal of Gastroenterology. 2009;104 Suppl 1:S1-S35.
  3. Park DW, Lee OY, Shim SG, Jun DW, Lee KN, Kim HY, et al. The differences in prevalence and sociodemographic characteristics of irritable bowel syndrome according to Rome II and Rome III. Journal of Neurogastroenterology and Motility. 2010;16(2):186-193. https://doi.org/10.5056/jnm.2010.16.2.186
  4. Yoo JS. New strategies in irritable bowel syndrome. Journal of Korean Life Insurance Medical Association. 2002;21:23-31.
  5. Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications? Gastroenterology. 2002;122(4):1140-1156. https://doi.org/10.1053/gast.2002.32392
  6. Read N, Rampersad-Smith L. Treating IBS in practice: A new aspect of care. Practice Nursing. 2013;24(11):538-542. https://doi.org/10.12968/pnur.2013.24.11.538
  7. Levy RL, Olden KW, Naliboff BD, Bradley LA, Francisconi C, Drossman DA, et al. Psychosocial aspects of the functional gastrointestinal disorders. Gastroenterology. 2006;130(5):1447-1458. https://doi.org/10.1053/j.gastro.2005.11.057
  8. Creed F, Ratcliffe J, Fernandes L, Palmer S, Rigby C, Tomenson B, et al. Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders. The British Journal of Psychiatry. 2005;186(6):507-515. https://doi.org/10.1192/bjp.186.6.507
  9. Park H. The pathophysiology of irritable bowel syndrome: Inflammation and motor disorder. The Korean Journal of Gastroenterology. 2006;47(2):101-110.
  10. Kearney DJ, Brown-Chang J. Complementary and alternative medicine for IBS in adults: Mind-body interventions. Nature Clinical Practice Gastroenterology & Hepatology. 2008;5(11):624-636. https://doi.org/10.1038/ncpgasthep1257
  11. National Center for Complementary and Integrative Health (NIH). Complementary, alternative, or integrative health: What's in a name? [Internet]. Bethesda: NIH; c2018 [cited 2018 Mar 22]. Available from: https://nccih.nih.gov/health/integrative-health.
  12. Wahbeh H, Elsas SM, Oken BS. Mind-body interventions: Applications in neurology. Neurology. 2008;70(24):2321-2328. https://doi.org/10.1212/01.wnl.0000314667.16386.5e
  13. Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. London: The Cochrane Collaboration; c2011 [cited 2017 Mar 22]. Available from: http://handbook.cochrane.org.
  14. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ: British Medical Journal. 2009;339:b2535. https://doi.org/10.1136/bmj.b2535
  15. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ: British Medical Journal. 2003;327(7414):557-560. https://doi.org/10.1136/bmj.327.7414.557
  16. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ: British Medical Journal. 1997;315(7109):629-634. https://doi.org/10.1136/bmj.315.7109.629
  17. Mulak A, Bonaz B. Irritable bowel syndrome: A model of the brain-gut interactions. Medical Science Monitor. 2004;10(4):RA55-RA62.
  18. Fichna J, Storr MA. Brain-gut interactions in IBS. Frontiers in Pharmacology. 2012;3:127. https://doi.org/10.3389/fphar.2012.00127
  19. Heymann-Monnikes I, Arnold R, Florin I, Herda C, Melfsen S, Monnikes H. The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. The American Journal of Gastroenterology. 2000;95(4):981-994. https://doi.org/10.1016/S0002-9270(00)00729-2
  20. Blanchard EB, Schwarz SP, Suls JM, Gerardi MA, Scharff L, Greene B, et al. Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome. Behaviour Research and Therapy. 1992;30(2):175-189. https://doi.org/10.1016/0005-7967(92)90141-3
  21. Boyce PM, Talley NJ, Balaam B, Koloski NA, Truman G. A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome. The American Journal of Gastroenterology. 2003;98(10):2209-2218. https://doi.org/10.1016/S0002-9270(03)00749-4
  22. Shinozaki M, Kanazawa M, Kano M, Endo Y, Nakaya N, Hongo M, et al. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: A randomized controlled trial. Applied Psychophysiology and Biofeedback. 2010;35(3):189-198. https://doi.org/10.1007/s10484-009-9125-y
  23. Taneja I, Deepak KK, Poojary G, Acharya IN, Pandey RM, Sharma MP. Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: A randomized control study. Applied Psychophysiology and Biofeedback. 2004;29(1):19-33. https://doi.org/10.1023/b:apbi.0000017861.60439.95
  24. Hillila MT, Siivola MT, Farkkila MA. Comorbidity and use of health-care services among irritable bowel syndrome sufferers. Scandinavian Journal of Gastroenterology. 2007;42(7):799-806. https://doi.org/10.1080/00365520601113927
  25. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: Development and validation of a new measure. Digestive Diseases and Sciences. 1998;43(2):400-411. https://doi.org/10.1023/a:1018831127942
  26. Roberts L, Wilson S, Singh S, Roalfe A, Greenfield S. Gut-directed hypnotherapy for irritable bowel syndrome: Piloting a primary care-based randomised controlled trial. The British Journal of General Practice. 2006;56(523):115-121.
  27. Kennedy PJ, Clarke G, Quigley EMM, Groeger JA, Dinan TG, Cryan JF. Gut memories: Towards a cognitive neurobiology of irritable bowel syndrome. Neuroscience and Biobehavioral Reviews. 2012;36(1):310-340. https://doi.org/10.1016/j.neubiorev.2011.07.001
  28. Labus J, Gupta A, Gill HK, Posserud I, Mayer M, Raeen H, et al. Randomised clinical trial: Symptoms of the irritable bowel syndrome are improved by a psycho-education group intervention. Alimentary Pharmacology and Therapeutics. 2013;37(3):304-315. https://doi.org/10.1111/apt.12171
  29. Jarrett ME, Cain KC, Burr RL, Hertig VL, Rosen SN, Heitkemper MM. Comprehensive self-management for irritable bowel syndrome: Randomized trial of in-person vs. combined in-person and telephone sessions. The American Journal of Gastroenterology. 2009;104(12):3004-3014. https://doi.org/10.1038/ajg.2009.479
  30. Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann DJ, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: Results of a randomized controlled trial. The American Journal of Gastroenterology. 2011;106(9):1678-1688. https://doi.org/10.1038/ajg.2011.184
  31. Moser G, Tragner S, Gajowniczek EE, Mikulits A, Michalski M, Kazemi-Shirazi L, et al. Long-term success of GUT-directed group hypnosis for patients with refractory irritable bowel syndrome: A randomized controlled trial. The American Journal of Gastroenterology. 2013;108(4):602-609. https://doi.org/10.1038/ajg.2013.19
  32. Kopczynska M, Mokros L, Pietras T, Malecka-Panas E. Quality of life and depression in patients with irritable bowel syndrome. Przeglad Gastroenterologiczny. 2018;13(2):102-108. https://doi.org/10.5114/pg.2018.75819
  33. Tosic-Golubovic S, Miljkovic S, Nagorni A, Lazarevic D, Nikolic G. Irritable bowel syndrome, anxiety, depression and personality characteristics. Psychiatria Danubina. 2010;22(3):418-424.
  34. Miller V, Hopkins L, Whorwell PJ. Suicidal ideation in patients with irritable bowel syndrome. Clinical Gastroenterology and Hepatology. 2004;2(12):1064-1068. https://doi.org/10.1016/s1542-3565(04)00545-2
  35. Layer P, Andresen V, Pehl C, Allescher H, Bischoff SC, Classen M, et al. [Irritable bowel syndrome: German consensus guidelines on definition, pathophysiology and management]. Zeitschrift fur Gastroenterologie. 2011;49(2):237-293. German. https://doi.org/10.1055/s-0029-1245976
  36. Wang W, Wang F, Fan F, Sedas AC, Wang J. Mind-body interventions for irritable bowel syndrome patients in the Chinese population: A systematic review and meta-analysis. International Journal of Behavioral Medicine. 2017;24(2):191-204. https://doi.org/10.1007/s12529-016-9589-0

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