许凌云 陈思玮 刘欢宇 冉艳 陈宁宁 孙林 陈余 厉英超

    [摘要] 炎症性肠病(IBD)患者心理问题的发生率显著高于普通人群，其中最受关注的是焦虑、抑郁及慢性腹痛等。脑-肠轴的紊乱是IBD疾病活动与心理问题双向影响的重要机制。IBD患者心理状态的评估和规范化治疗日益受到重视。心理治疗是对IBD传统治疗的重要补充，不但可减轻IBD患者焦虑、抑郁及慢性腹痛等症状，还可降低IBD疾病活动度，预防不必要的治疗升级，提高患者生活质量，改变疾病的自然史。一种IBD的“生物-心理-社会”综合治疗新模式正在形成。本文对IBD常见心理问题及其与IBD疾病活动的双向影响及机制、诊断及治疗进展进行了综述。

    [关键词] 炎症性肠病;心理问题;脑-肠轴;双向影响;心理评估;心理治疗

    [中图分类号] R574? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-7210(2020)09(a)-0049-04

    [Abstract] The Patients with inflammatory bowel disease (IBD) have significantly higher rates of psychological issues than the general population. Anxiety， depression and chronic abdominal pain are the most notable. The disorder of brain-gut axis is the important mechanism in bi-directional interactions between IBD disease activity and psychological issues. More and more attention has been paid to the diagnostic approaches of psychological conditions and standardized psychological treatments in IBD. Psychotherapy， an important supplement to the traditional treatment of IBD， can not only reduce the symptoms of psychological issues in IBD patients， but also reduce the activity of IBD disease. Moreover it can prevent unnecessary treatment escalation and improve the quality of life of patients. It can also change the disease course. A new “bio-psycho-social” medical model of IBD is emerging. This article reviews the common psychological issues in IBD patients ......