Chinese General Practice ›› 2024, Vol. 27 ›› Issue (24): 2941-2953.DOI: 10.12114/j.issn.1007-9572.2024.0030
Special Issue: 指南/共识最新文章合辑
• Guidelines·Consensus • Next Articles
Received:
2024-03-05
Revised:
2024-04-20
Published:
2024-08-20
Online:
2024-05-08
Contact:
CHEN Jue
通讯作者:
陈珏
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2024.0030
推荐强度 | 证据级别 | 病因、治疗、预防 |
---|---|---|
A | 1a | 多个同质随机对照研究的系统综述 |
1b | 单个随机对照研究 | |
1c | "全或无"证据 | |
B | 2a | 同质性队列研究的系统综述 |
2b | 单一的队列研究(包括低质量的随机对照研究,如随访率<80%) | |
2c | 结局性研究 | |
3a | 同质性病例对照研究的系统综述 | |
3b | 单独的病例对照研究 | |
C | 4 | 病例系列 |
D | 5 | 没有严格评价的专家意见,或完全基于生理学和基础研究 |
Table 1 The level of evidence graded by the OCEBM
推荐强度 | 证据级别 | 病因、治疗、预防 |
---|---|---|
A | 1a | 多个同质随机对照研究的系统综述 |
1b | 单个随机对照研究 | |
1c | "全或无"证据 | |
B | 2a | 同质性队列研究的系统综述 |
2b | 单一的队列研究(包括低质量的随机对照研究,如随访率<80%) | |
2c | 结局性研究 | |
3a | 同质性病例对照研究的系统综述 | |
3b | 单独的病例对照研究 | |
C | 4 | 病例系列 |
D | 5 | 没有严格评价的专家意见,或完全基于生理学和基础研究 |
心理治疗类型 | 治疗目标 | 推荐疗程 | 推荐强度/证据级别 |
---|---|---|---|
认知行为治疗 | 第一阶段:自我监测,识别有问题的饮食模式,建立正常的饮食模式 第二阶段以认知为导向,包括教患者识别和重建关于其身体形象和饮食的适应不良想法(即"认知重建"),以及教授解决问题的技能,以更好地应对压力情况、人际互动和暴食的触发因素 第三阶段的重点是保持正常饮食,巩固新的认知和解决问题的能力,并学习预防复发的方法 | 12~24周,每周1次 | A1a |
辩证行为治疗 | 使BED患者发展出具有适应性的情绪调节技能,并能在日常生活中应用 | 1年,包含有(1)每周与治疗师的单独会谈;(2)每周在团体中的技能训练;(3)两次会谈期间通过电话进行的技能指导;(4)DBT治疗师团队每周一起讨论病情及治疗进展,以支持治疗(患者不参与) | B3a |
人际心理治疗 | 聚焦于识别和改变导致暴食问题发生、发展和持续的人际关系问题 | 4~5个月,15~20次访谈 | B3a |
正念饮食觉知训练 | 正念被整合到与食物渴望和饮食相关的日常活动中。其基于我们目前对食物摄入调节过程的了解,包括觉察饥饿和饱胀感,将主要注意力放在饮食模式上 | 10次,包含有正念、正念饮食、情绪平衡、自我接纳 | B2b |
行为减重治疗 | 一种结构化的行为生活方式方法,让患者在正常化和构建饮食模式的同时增加身体活动。适合BED合并肥胖的患者,应联合使用CBT或药物治疗 | B3a |
Table 2 Recommendations for psychotherapy in BED patients
心理治疗类型 | 治疗目标 | 推荐疗程 | 推荐强度/证据级别 |
---|---|---|---|
认知行为治疗 | 第一阶段:自我监测,识别有问题的饮食模式,建立正常的饮食模式 第二阶段以认知为导向,包括教患者识别和重建关于其身体形象和饮食的适应不良想法(即"认知重建"),以及教授解决问题的技能,以更好地应对压力情况、人际互动和暴食的触发因素 第三阶段的重点是保持正常饮食,巩固新的认知和解决问题的能力,并学习预防复发的方法 | 12~24周,每周1次 | A1a |
辩证行为治疗 | 使BED患者发展出具有适应性的情绪调节技能,并能在日常生活中应用 | 1年,包含有(1)每周与治疗师的单独会谈;(2)每周在团体中的技能训练;(3)两次会谈期间通过电话进行的技能指导;(4)DBT治疗师团队每周一起讨论病情及治疗进展,以支持治疗(患者不参与) | B3a |
人际心理治疗 | 聚焦于识别和改变导致暴食问题发生、发展和持续的人际关系问题 | 4~5个月,15~20次访谈 | B3a |
正念饮食觉知训练 | 正念被整合到与食物渴望和饮食相关的日常活动中。其基于我们目前对食物摄入调节过程的了解,包括觉察饥饿和饱胀感,将主要注意力放在饮食模式上 | 10次,包含有正念、正念饮食、情绪平衡、自我接纳 | B2b |
行为减重治疗 | 一种结构化的行为生活方式方法,让患者在正常化和构建饮食模式的同时增加身体活动。适合BED合并肥胖的患者,应联合使用CBT或药物治疗 | B3a |
[1] |
陈珏. 进食障碍[M]. 北京:人民卫生出版社,2013.
|
[2] |
王向群,王高华. 中国进食障碍防治指南[M]. 北京:中华医学电子音像出版社,2015.
|
[3] |
|
[4] |
|
[5] |
|
[6] |
|
[7] |
|
[8] |
|
[9] |
|
[10] |
|
[11] |
National Institute for Health and Care Excellence (NICE). Eating Disorders:recognition and treatment Eating disorders[M]. London:National Institute for Health and Care Excellence (NICE),2020:1-69.
|
[12] |
|
[13] |
|
[14] |
|
[15] |
|
[16] |
|
[17] |
|
[18] |
|
[19] |
|
[20] |
|
[21] |
|
[22] |
|
[23] |
|
[24] |
|
[25] |
|
[26] |
|
[27] |
|
[28] |
|
[29] |
|
[30] |
|
[31] |
|
[32] |
|
[33] |
National Collaborating Centre for Mental Health(UK). Eating disorders:core interventions in the treatment and management of anorexia nervosa,bulimia nervosa and related eating disorders[J]. British Psychological Dociety,2004.
|
[34] |
|
[35] |
|
[36] |
|
[37] |
|
[38] |
|
[39] |
|
[40] |
|
[41] |
|
[42] |
|
[43] |
|
[44] |
|
[45] |
|
[46] |
|
[47] |
|
[48] |
|
[49] |
|
[50] |
|
[51] |
|
[52] |
|
[53] |
|
[54] |
|
[55] |
|
[56] |
|
[57] |
|
[58] |
|
[59] |
|
[60] |
|
[61] |
|
[62] |
|
[63] |
|
[64] |
|
[65] |
|
[66] |
|
[67] |
|
[68] |
|
[69] |
|
[70] |
|
[71] |
|
[72] |
|
[73] |
|
[74] |
|
[75] |
|
[76] |
|
[77] |
|
[78] |
|
[79] |
|
[80] |
|
[81] |
|
[82] |
|
[83] |
|
[84] |
|
[85] |
|
[86] |
|
[87] |
|
[88] |
|
[89] |
|
[90] |
|
[91] |
|
[92] |
|
[93] |
|
[94] |
|
[95] |
|
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