重新思考乳糜泻护理：为何心理理解至关重要 - 健康研究

重新思考乳糜泻护理：为何心理理解至关重要Rethinking coeliac disease care: why psychological understanding matters - The Lancet Gastroenterology & Hepatology

环球医讯 / 健康研究来源：www.thelancet.com英国 - 英文2026-10-10 00:09:18 - 阅读时长5分钟 - 2164字

乳糜泻影响全球约1.4%的人口，是唯一已知环境触发因素（麸质）的自身免疫性胃肠疾病。治疗完全依赖终身严格的无麸质饮食，但依从率因定义和评估方法不同仅在42%至91%之间。未控制的乳糜泻可导致营养缺乏、骨病、皮肤表现、内分泌疾病及恶性肿瘤等多种全身并发症。本文提出应重视乳糜泻护理中的心理因素，强调整合心理支持对改善患者预后的必要性。

乳糜泻影响全球约1.4%的人口。它是唯一已知环境触发因素（麸质）的自身免疫性胃肠疾病。治疗完全依赖终身严格的无麸质饮食。尽管无麸质饮食管理的原则已明确，但严格依从率的报告差异较大，约为42%至91%，具体取决于所使用的定义和评估方法。若未得到妥善管理，乳糜泻与一系列全身并发症相关，包括营养缺乏、骨病、皮肤表现、内分泌疾病及恶性肿瘤。

参考文献：

Singh P, Arora A, Strand TA, et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018;16:823-836.
Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther. 2009;30:315-330.
Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet. 2018;391:70-81.
National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management (NG17). NICE, London, 2022.
National Institute for Health and Care Excellence. Irritable bowel syndrome in adults: diagnosis and management (CG61). NICE, London, 2017.
Rose C, Law GU, Howard RA. The psychosocial experiences of adults diagnosed with coeliac disease: a qualitative evidence synthesis. Qual Life Res. 2024;33:1-16.
Clappison E, Hadjivassiliou M, Zis P. Psychiatric manifestations of coeliac disease: a systematic review and meta-analysis. Nutrients. 2020;12:142.
Addolorato G, Capristo E, Ghittoni G, et al. Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: a longitudinal study. Scand J Gastroenterol. 2001;36:502-506.
Kerswell NL, Strodl E. Emotion and its regulation predicts gluten-free diet adherence in adults with coeliac disease. Health Psychol Behav Med. 2015;3:52-68.
Sainsbury K, Mullan B. Measuring beliefs about gluten free diet adherence in adult coeliac disease using the theory of planned behaviour. Appetite. 2011;56:476-483.
Sainsbury K, Mullan B, Sharpe L. A randomized controlled trial of a theory-based intervention to improve gluten-free diet adherence. Am J Gastroenterol. 2013;108:811-817.
Chey WD, Kurlander J, Eswaran S. Integrated care for disorders of gut–brain interaction. Lancet Gastroenterol Hepatol. 2020;5:876-877.
National Institute for Health and Care Research. Designing integrated dietetic and psychological NHS pathways for adults living with coeliac disease (NIHR205380). NIHR, London, 2025.

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