Pages: 201-208
1387 ﺰﻴﻳﺎﭘ،3 ﻩﺭﺎﻤﺷ،2 ﻩﺭﻭﺩ
201-208:ﺕﺎﺤﻔﺻ
Abstract
Introduction: This study was aimed to investigate two kinds of treatment in patients with Irritable Bowel Syndrome and compare their efficacy on improving patients’ symptoms and their mental health; one with just medical treatment and another with a combination of psychotherapy and medical treatment.
Method: In a quasi-experimental study, 50 IBS patients were chosen among patients who came to a Gastroenterology Clinic. They were physically evaluated using ROME-II and mentally evaluated using SCL-90-R and then randomly appointed to two groups: medical treatment group as the control group and the combination of medical and psychological treatment as the case group. The subjects at the case group received cognitive behavioral psychotherapy for 8 sessions. Then, both the case and the control groups were evaluated using ROME-II and SCL-90-R. The data were analyzed using t test and U Mann-Whitney test for independent groups.
Results: The findings of this study showed that a combination of cognitive behavioral therapy and medical treatment is more effective than medical treatment alone in alleviating IBS symptoms. The mental health of the case was meaningfully better than that of the control.
Conclusion: Considering the role of cognitive behavioral therapy combined with medical treatment in IBS patients, we recommend that a team of gastroenterologists and psychologists manage such patients.
Key words: Irritable Bowel Syndrome, Cognitive behavioral therapy, Medical treatment, Psychological status
ﻩﺪﻴﻜﭼ
ﻥﺍﻭﺭﺵﻭﺭﻭﺩﻪــﺴﻳﺎﻘﻣﻑﺪــﻫﺎﺑﺮﺿﺎﺣﺶــﻫﻭﮋﭘ :ﻪـﻣﺪﻘﻣ
ﻥﺎﻣﺭﺩﺭﺩﻯﺮــﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﺎــﺑﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮــﮕﻧﺎﻣﺭﺩ ﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳءﺎﻘﺗﺭﺍﻭ (IBS) ﺮﻳﺬﭘﻚﻳﺮﺤﺗﻩﺩﻭﺭﻡﺭﺪﻨﺳ
.ﺪﻳﺩﺮﮔﺍﺮﺟﺍﻝﻼﺘﺧﺍﻦﻳﺍﻪﺑﻼﺘﺒﻣﺩﺍﺮﻓﺍ IBSﻪﺑﻼﺘﺒﻣﺩﺍﺮﻓﺍﺯﺍﺮﻔﻧ 50 ،ﻰﺑﺮﺠﺗﻪﺒﺷﺡﺮﻃﻚﻳﺭﺩ :ﺵﻭﺭ
ﺎﺑﺵﺭﺍﻮﮔﻰﺼﺼﺨﺗﻚﻴﻨﻴﻠﻛﻪﺑﻩﺪﻨﻨﻛﻪﻌﺟﺍﺮﻣﻥﺍﺭﺎﻤﻴﺑﻦــﻴﺑﺯﺍ ﺲﭘﻭﺪﻧﺪﺷﺏﺎﺨﺘﻧﺍﺱﺮﺘﺳﺩﺭﺩﻯﺮﻴﮔﻪﻧﻮﻤﻧﺵﻭﺭﺯﺍﻩﺩﺎﻔﺘﺳﺍ ﺢﻄﺳﻥﺍﺰﻴﻣﻭROM-IIﺱﺎﻴﻘﻣﺯﺍﻩﺩﺎﻔﺘﺳﺍﺎﺑﻪﻴﻟﻭﺍﻰﺑﺎﻳﺯﺭﺍﺯﺍ ﺕﺭﻮﺼﺑ،SCL-90-Rﻪﻣﺎﻨﺸﺳﺮﭘﺯﺍﻩﺩﺎﻔﺘﺳﺍﺎﺑﻰﻧﺍﻭﺭﺖﻣﻼــﺳ ﻭﻝﺮﺘﻨﻛﻩﻭﺮﮔﻥﺍﻮﻨﻋﻪﺑﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩ) ﻩﻭﺮﮔﻭﺩﺭﺩﻰــﻓﺩﺎﺼﺗ ﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭ ﻯﺎﻫﻰﻧﺩﻮﻣﺯﺁ .ﺪﻧﺪــﺷﻦﻳﺰﮕﻳﺎﺟ (ﻰــﺸﻳﺎﻣﺯﺁﻩﻭﺮــﮔﻥﺍﻮﻨﻋﻪــﺑ
-ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺖﺤﺗﻪﺴﻠﺟ 8 ﻰﻃﻰــﺸﻳﺎﻣﺯﺁﻩﻭﺮﮔ ًﺍﺩﺪﺠﻣﻩﻭﺮﮔﻭﺩﺮﻫﻯﺎﻫﻰﻧﺩﻮﻣﺯﺁﺲﭙﺳ .ﺪﻨﺘﻓﺮﮔﺭﺍﺮﻗﻰﺘﺧﺎﻨــﺷ ﻰﺑﺎﻳﺯﺭﺍﺩﺭﻮﻣSCL-90-RﻪﻣﺎﻨــﺸﺳﺮﭘﻭROM-IIﺱﺎﻴﻘﻣﺎﺑ ﻯﺍﺮﺑtﻥﻮﻣﺯﺁﺯﺍﻩﺩﺎﻔﺘﺳﺍﺎﺑﻩﺪﻣﺁﺖــﺳﺪﺑﻯﺎﻫﻩﺩﺍﺩ .ﺪﻨﺘﻓﺮﮔﺭﺍﺮﻗ
.ﺖﻓﺮﮔﺭﺍﺮﻗﻞﻴﻠﺤﺗﻭﻪﻳﺰﺠﺗﺩﺭﻮﻣﻞﻘﺘﺴﻣﻯﺎﻬﻫﻭﺮﮔ ﻥﺍﻭﺭﺵﻭﺭﻪــﻛﺩﺍﺩﻥﺎــﺸﻧﻩﺪﻣﺁﺖــﺳﺪﺑﺞﻳﺎﺘﻧ :ﺎـﻫﻪـﺘﻓﺎﻳ
ﺶﻴﺑ،ﻱﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻲﺘﺧﺎﻨــﺷ –ﻱﺭﺎﺘﻓﺭﻱﺮﮕﻧﺎﻣﺭﺩ ﺖــﺳﺍﺮﺛﻮﻣIBSﻢﺋﻼﻋﺩﻮﺒﻬﺑﺭﺩ،ﻲﻳﺎﻬﻨﺗﻪﺑﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﺯﺍ ﺮﺘﺸﻴﺑﻯﺭﺍﺩﺎﻨﻌﻣﺭﻮﻄﺑﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﺭﺩﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳﻭ
.ﺩﻮﺑﻝﺮﺘﻨﻛﻩﻭﺮﮔﺯﺍ
-ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺶــﻘﻧﻪﺑﻪﺟﻮﺗﺎﺑ :ﻯﺮـﻴﮔﻪﺠﻴﺘﻧ
ﻼﺘﺒﻣﻥﺍﺭﺎﻤﻴﺑﻥﺎــﻣﺭﺩﺭﺩﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮــﻤﻫﻪﺑﻰﺘﺧﺎﻨــﺷ ﻰﻤﻴﺗﺕﺭﻮﺻﻪﺑﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍﻥﺎﻣﺭﺩﺩﻮﺷﻰﻣﺩﺎﻬﻨــﺸﻴﭘIBSﻪﺑ ﻭﻲﻜــﺷﺰﭙﻧﺍﻭﺭﻥﺎﺼﺼﺨﺘﻣﻭﺵﺭﺍﻮــﮔﻥﺎﺼﺼﺨﺘﻣﺯﺍﺐــﻛﺮﻣ
.ﺩﺮﻴﮔﺕﺭﻮﺻﻰﺳﺎﻨﺸﻧﺍﻭﺭ ﻭﺭﺍﺩ،ﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭ :ﻱﺪﻴﻠﻛﻯﺎﻫﻩژﺍﻭ
ﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭﺖﻴﻌﺿﻭ،ﺮﻳﺬﭘﻚﻳﺮﺤﺗﻩﺩﻭﺭﻡﺭﺪﻨﺳ،ﻯﺮﮕﻧﺎﻣﺭﺩ
ﻯﺮﮕﻧﺎﻣﺭﺩ
ﻭﺭﺍﺩ
ﺎﺑ
ﻰﺘﺧﺎﻨﺷ
-
ﻯﺭﺎﺘﻓﺭ
ﻯﺮﮕﻧﺎﻣﺭﺩ
ﻥﺍﻭﺭ
ﻪﺴﻳﺎﻘﻣ
IBS
ﻪﺑ
ﻼﺘﺒﻣ
ﺩﺍﺮﻓﺍ
ﻥﺎﻣﺭﺩ
ﻭ
ﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭ
ﺖﻴﻌﺿﻭ
ﺮﺑ
IBS Treatment: Cognitive Behavioral Therapy
vs Medical Treatment
Mahvi-Shirazi, M. Ph.D., Fathi-Ashtiani, A. Ph.D., Rasoolzade-Tabatabaei, S.K. Ph.D., Amini, M. M.D.
،*ﻰﻧﺎﻴﺘﺷﺁﻰﺤﺘﻓﻰﻠﻋﺮﺘﻛﺩ،"ﻯﺯﺍﺮﻴﺷﻯﻮﺤﻣﺪﻴﺠﻣﺮﺘﻛﺩ
***ﻰﻨﻴﻣﺍﻦﺴﺤﻣﺮﺘﻛﺩ،**ﻲﻳﺎﺒﻃﺎﺒﻃﻩﺩﺍﺯﻝﻮﺳﺭﻢﻇﺎﻛﺪﻴﺳﺮﺘﻛﺩ
# Corresponding author: Department of
Psychology, Tarbiat Modarres University, Tehran, Iran
ﻲﺳﺎﻨﺸﻧﺍﻭﺭﻩﻭﺮﮔ،ﺍﺮﻫﺯﻦﻴﺋﻮﺑﺪﺣﺍﻭﺩﺍﺯﺁﻩﺎﮕﺸﻧﺍﺩ :ﻝﻮﺌﺴﻣﻩﺪﻨﺴﻳﻮﻧ"
ﻯﺭﺎﺘﻓﺭﻡﻮﻠﻋﺕﺎﻘﻴﻘﺤﺗﺰﻛﺮﻣ،ﻰﺳﺎﻨﺸﻧﺍﻭﺭﻩﻭﺮﮔ،ﷲﺍﻪﻴﻘﺑﻰﻜﺷﺰﭘﻡﻮﻠﻋﻩﺎﮕﺸﻧﺍﺩﺩﺎﺘﺳﺍ *
ﻰﺳﺎﻨﺸﻧﺍﻭﺭﻩﻭﺮﮔ،ﺱﺭﺪﻣﺖﻴﺑﺮﺗﻩﺎﮕﺸﻧﺍﺩﺭﺎﻳﺩﺎﺘﺳﺍ ** 87/4/25 :ﺖﻓﺎﻳﺭﺩﺦﻳﺭﺎﺗ
ﻪﻣﺪﻘﻣ
ﻰــﺸﻨﻛﻝﻼﺘﺧﺍﻚﻳ،IBSﺎﻳ1ﺮﻳﺬﭘﻚــﻳﺮﺤﺗﻩﺩﻭﺭﻥﺎﮕﻧﺎــﺸﻧﻰﻤﺋﻼﻋﺎﺑ،ﻰﻨﻴﻟﺎﺑﺮﻈﻧﻪﻄﻘﻧﺯﺍﻪﻛﺖــﺳﺍﻰــﺷﺭﺍﻮﮔﻩﺎﮕﺘــﺳﺩ
،ﻰﻤﻜﺷﻉﺎﺴﺗﺍﺱﺎﺴﺣﺍﻭﺩﺭﺩ،ﺝﺍﺰﻣﺖﺑﺎﺟﺍﺖﻴﻌﺿﻭﺮﻴﻴﻐﺗﻥﻮﭼ
ﺖﻴﻌﻤﺟﺪﺻﺭﺩ20ﺎﺗ10 ﺩﻭﺪﺣﻥﺁﻉﻮﻴﺷ .ﺩﻮﺷﻰﻣﻩﺩﺍﺩﺺﻴﺨﺸﺗ
ﺎﺑﻪﺴﻳﺎﻘﻣﺭﺩﻪﻛﺖﺳﺍﻰﺷﺭﺍﻮﮔﻝﻼﺘﺧﺍﻦﻳﺮﺗﻊﻳﺎﺷﻭﻩﺩﻮﺑﻰﻠﻛ
،2(IBD) ﻩﺩﻭﺭﻰﺑﺎﻬﺘﻟﺍﻯﺭﺎﻤﻴﺑﻞﻴﺒﻗﺯﺍﻰﺷﺭﺍﻮﮔﺕﻻﻼﺘﺧﺍﺮﮕﻳﺩ
.[1] ﺖﺳﺍﻁﺎﺒﺗﺭﺍﺭﺩﻰﻋﺎﻤﺘﺟﺍ-ﻰﻧﺍﻭﺭﻞﻣﺍﻮﻋﺎﺑﺮﺘﺸﻴﺑ
ﻥﺁﺯﺍﻰﻛﺎﺣﻰــﺸﻫﻭﮋﭘﻯﺎﻫﻪﺘﻓﺎﻳ،IBSﻥﺎــﻣﺭﺩﺎﺑﻁﺎــﺒﺗﺭﺍﺭﺩ
ﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﻡﺎﻏﺩﺍ،ﻰﺒﻴﻛﺮﺗﻯﺎﻬــﺷﻭﺭﺯﺍﻩﺩﺎﻔﺘــﺳﺍﻪﻛﺖﺳﺍ
،ﻯﺭﺎﺘﻓﺭ -ﻰﺘﺧﺎﻨــﺷﺎﺻﻮﺼﺧ،ﻰﻧﺎﻣﺭﺩﻥﺍﻭﺭﻯﺎﻬــﺷﻭﺭﺎﺑﺞﻳﺍﺭ
.ﺖﺳﺍﻪﺘﺷﺍﺩﻥﺎﮕﻧﺎﺸﻧﻦﻳﺍﻢﺋﻼﻋﺭﺎﻬﻣﺭﺩﻰﻬﺟﻮﺗﻞﺑﺎﻗﺦــﺳﺎﭘ
،ﻩﺪﺷﺎﻨﺑﻰﺘﺧﺎﻨﺷ -ﻯﺭﺎﺘﻓﺭﻯﺎﻬﻜﻴﻨﻜﺗﻪﻳﺎﭘﺮﺑﻪﻛﻰﻳﺎﻬﻧﺎﻣﺭﺩﺍﺬﻟ
ﻪﺑIBSﻰﻧﺎﻣﺭﺩﻯﺎــﻫﻪﻳﺮﻈﻧﻪﻨﻴﻣﺯﺭﺩﺍﺭﻯﺪــﻳﺪﺟﻯﺎﻬــﺸﻟﺎﭼ
ﻪﻨﻴﺸﻴﭘﺮﺑﺍﺭﺬﮔﻰﻫﺎﮕﻧﺎﺑﺮﮕﻳﺩﻑﺮﻃﺯﺍ .[2] ﺖﺳﺍﻪﺘﺷﺍﺩﻩﺍﺮﻤﻫ
ﻦﻳﺍﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭﺪﻌﺑﺶﻴﭘﺯﺍﺶﻴﺑﻦــﻴﻴﺒﺗﺕﺭﻭﺮﺿ،ﻖــﻴﻘﺤﺗ
ﻪﻛﺪﻧﺍﻩﺩﺍﺩﻥﺎﺸﻧﺕﺎﻘﻴﻘﺤﺗﺯﺍﻰﺧﺮﺑﺞﻳﺎﺘﻧ .ﺖﺳﺍﺡﺮﻄﻣﻯﺭﺎﻤﻴﺑ
ﻩﺍﺮﻤﻫﻪﺑ3(CBT) ﻰﺘﺧﺎﻨﺷ –ﻯﺭﺎﺘﻓﺭﻰﻧﺎﻣﺭﺩﻥﺍﻭﺭﻯﺎﻬــﺷﻭﺭ
ﺞﻳﺎﺘﻧﻪﺑﻰﻧﺎﻣﺭﺩﻭﺭﺍﺩﻪﺑﺖﺒﺴﻧIBSﻥﺎﻣﺭﺩﺭﺩﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩ
ﻰﻌﻄﻘﻣﻪﻌﻟﺎﻄﻣﻚﻳﺞﻳﺎﺘﻧ .[3-6] ﺖــﺳﺍﻪﺘﻓﺎﻳﺖﺳﺩﻰﺗﻭﺎﻔﺘﻣ
ﻩﺩﻮﺑﻩﺍﺮﻤﻫﻰﻳﻻﺎﺑﻯﺎﻫﺱﺮﺘــﺳﺍﺎﺑ،IBSﻪﻛﺩﻮﺑﻥﺁﺮﮕﻧﺎــﺸﻧ
ﻢﺋﻼﻋ،ﺪﻧﺍﻩﺩﻮﺑﺩﻮﺧﻥﺎﻣﺭﺩﺩﺪﺻﺭﺩﺎﻤﺋﺍﺩﻪﻛﻰﻧﺍﺭﺎﻤﻴﺑﻭﺖــﺳﺍ
ﻪﻌﻟﺎﻄﻣﺭﺩﻩﻭﻼﻌﺑ .[7] ﺪﻧﺍﻩﺩﺍﺩﻥﺎــﺸﻧﻯﺮﺗﺪﻳﺪﺷﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭ
ﻰﻧﺎﻣﺭﺩﺩﺮــﻜﻳﻭﺭﻚﻳIBSﻥﺎﻣﺭﺩ،ﺪــﺷﻩﺩﺍﺩﻥﺎــﺸﻧﻯﺮﮕﻳﺩ
ﻢﻳژﺭﺮﻴﻴﻐﺗ،ﻰﻳﻭﺭﺍﺩﻥﺎــﻣﺭﺩﻞﻣﺎــﺷﻪﻛﺪﺒﻠﻃﻰﻣﺍﺭﻰﻬﺟﻭﺪﻨﭼ
ﻥﺎﺸﻧﻯﺮﮕﻳﺩﻖﻴﻘﺤﺗﺭﺩ .[8] ﺪــﺷﺎﺑﻰﻣﻰﻧﺎﻣﺭﺩﻥﺍﻭﺭﻭﻰﻳﺍﺬﻏ
ﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭًﺎــﺻﻮﺼﺧﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭﻯﺎﻬﻧﺎﻣﺭﺩ،ﺪــﺷﻩﺩﺍﺩ
ﺮﺑﻰﻨﺘﺒﻣﻰﻧﺎـﻣﺭﺪﻧﺍﻭﺭﻭﻰــﭘﺍﺮﺗﻮﻨـﭙﻴﻫ،ﻰﺘـﺧﺎﻨــﺷ - ﻯﺭﺎــﺘﻓﺭ
ﺮﺛﻮﻣIBSﻪﺑﻥﺎﻳﻼـﺘﺒﻣﻥﺎــﻣﺭﺩﺭﺩ،ﻰــﺸﻳﻮﭘﻥﺍﻭﺭﻯﺎﻬﻜﻴﻨﻜﺗ
.[5] ﺖﺳﺍ
8 ﻰﻃﺍﺭIBSﺺﻴﺨﺸﺗﺎﺑﺭﺎﻤﻴﺑ 7 ﺎﻴﻟﺍﺮﺘﺳﺍﺭﺩﻯﺍﻪﻌﻟﺎﻄﻣﻰﻃ
ﻰﺘﺧﺎﻨﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺵﻭﺭﺎﺑﻥﺎﻣﺭﺩﺖﺤﺗﻪﺴﻠﺟ
1 Irritable Bowel Syndrome 2 Inflammatory Bowel Disease
3 Cognitive-Behavioral Therapy
ﺩﺮﻜﻠﻤﻋﺮﻈﻧﺯﺍ،ﻥﺎــﻣﺭﺩﻉﻭﺮــﺷﺯﺍﻞﺒﻗﺩﺍﺮﻓﺍﻪﻴﻠﻛ .ﺪﻧﺩﺍﺩﺭﺍﺮــﻗ
ﺯﺍﺲﭘ .ﺪﻧﺪﺷﻰــﺳﺭﺮﺑﻯﺍﻩﺩﻭﺭﻢﺋﻼﻋﺕﺪــﺷﻭﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭ
ﺍﺭIBSﻰﺼﻴﺨــﺸﺗﻯﺎﻫﺭﺎﻴﻌﻣﺮﮕﻳﺩ،ﻥﺍﺭﺎﻤﻴﺑﺯﺍﺮﻔﻧ 5 ،ﻥﺎــﻣﺭﺩ
ﺶﻫﺎﻛﻥﺍﺭﺎﻤﻴﺑﻂــﺳﻮﺗﻢﺋﻼﻋﺯﺍﺮﺑﺍﺪﻨﭼﺮﻫﻩﻭﻼﻌﺑ .ﺪﻨﺘــﺷﺍﺪﻧ
ﻞﺑﺎﻗﺭﻮﻄﺑﺏﺍﺮﻄﺿﺍﻭﻰﮔﺩﺮﺴﻓﺍﻰﻧﺍﻭﺍﺮﻓ،ﺖــﺷﺍﺪﻧﻯﺮﻴﮕﻤﺸﭼ
ﺩﻮﺑﻥﺁﺯﺍﻰﻛﺎﺣﺞــﻳﺎﺘﻧﻰﻠﻛﺭﻮﻄﺑ .ﺩﻮﺑﻪﺘﻓﺎﻳﺶــﻫﺎﻛﻰﻬﺟﻮﺗ
ﺍﺭIBSﺯﺍﻰﺷﺎﻧﻰﻧﺍﻮﺗﺎﻧ،ﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻰﻧﺎﻣﺭﺩﺵﻭﺭﻪﻛ
ﻯﺮﻴﺛﺎﺗﺭﺎﻤﻴﺑﺩﻮﺧﻂــﺳﻮﺗﻢﺋﻼﻋﺭﺎﻬﻇﺍﺶﻫﺎﻛﺮﺑﺎﻣﺍ،ﻪﺘــﺳﺎﻛ
.[9] ﺖﺳﺍﻪﺘﺷﺍﺪﻧ
ﻰﻫﺎﮕﺸﻧﺍﺩﻰﺑﺍﺮﻄﺿﺍﺕﻻﻼﺘﺧﺍﻭﺱﺮﺘــﺳﺍﺰﻛﺮﻣﺭﺩﻰﺗﺎﻌﻟﺎﻄﻣ
ﻰﻧﺎﻣﺭﺩﻯﺎﻬــﺷﻭﺭﻪﻴﻠﻛﻥﺁﻰﻃﻭﺖــﻓﺮﮔﺕﺭﻮﺻﺎﻜــﻳﺮﻣﺁﺭﺩ
ﺪﻫﺍﻮﺷ،ﺪﻧﺪﺷﻰــﺳﺭﺮﺑIBSﻪﺑﻼﺘﺒﻣﺩﺍﺮﻓﺍﻯﺍﺮﺑﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭ
ﻯﻭﺎﻛﻥﺍﻭﺭﻭﻰــﻧﺎﻣﺭﺩﺖﺧﺎﻨــﺷ،ﻰﭘﺍﺮﺗﻮﻨﭙﻴﻫﻰﻳﺁﺭﺎﻛﺮــﺑﻝﺍﺩ
.[3] ﺖﺳﺍﻩﺪﻣﺁﺖﺳﺪﺑﺕﺪﻣﻩﺎﺗﻮﻛ
ءﺰﺟﻥﻮﭼﻯﺩﺭﺍﻮﻣﻪﺑﺪﻳﺎﺑﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭﻰﻧﺎﻣﺭﺩﻯﺎﻫﺩﺮﻜﻳﻭﺭﺭﺩ
.ﺖﺷﺍﺩﻪﺟﻮﺗﻥﺎﻨﻴﻤﻃﺍﻭﺖﻳﺎﻤﺣ،ﻰﺘﺧﺎﻨــﺸﻧﺍﻭﺭﺵﺯﻮﻣﺁءﺰﺟﻪﺑ
ﻰﻧﺎﻣﺭﺩﺖﺧﺎﻨــﺷﻪﺑﻁﻮﺑﺮﻣﺞﻳﺎﺘﻧﺵﺭﺎﻜﻤﻫﻭﺩﺭﺍﻭﺩﺍﻪﻌﻟﺎﻄﻣﺭﺩ
ﺪــﺳﺭﻰﻣﺮﻈﻧﻪﺑﻭﺖــﺳﺍﻩﺪــﺷﻰــﺳﺭﺮﺑًﺍﺭﺮﻜﻣﻰﭘﺍﺮﺗﻮﻨﭙﻴﻫﻭ
ﺕﺍﺮﺛﺍﻭﺪﻧﺍﻩﺩﻮــﺑﺶﺨﺑﺮﺛﺍًﻼﻣﺎﻛﺎﻤﻧﻭﺭﺍﺩﻩﻭﺮــﮔﺎﺑﻪــﺴﻳﺎﻘﻣﺭﺩ
ﻭﺖﺳﺍﻩﺪﻧﺎﻤﻴﻗﺎﺑﻝﺎﺳ 4 ﺩﻭﺪﺣﺎﺗﻰﻧﺎﻣﺭﺩﻥﺍﻭﺭﻯﺎﻬــﺷﻭﺭﺪﻴﻔﻣ
ﺖﻬﺟﺵﺭﺍﻮﮔﺺﺼﺨﺘﻣﻭﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﻦــﻴﺑﻚﻳﺩﺰﻧﻁﺎﺒﺗﺭﺍ
ﺖﺳﺍﻩﺩﻮﺑﺮﺛﻮﻣﺭﺎﻴــﺴﺑﻝﻼﺘﺧﺍﻦﻳﺍﻪﺑﻥﺎﻳﻼﺘﺒﻣﻢﺋﻼﻋﻝﺮﺘﻨﻛ
ﺩﺍﺩﻥﺎﺸﻧﺪﺷﻡﺎﺠﻧﺍ4ﺭﻮﻠﻴﺗﻂــﺳﻮﺗﻪﻛﻯﺍﻪﻌﻟﺎﻄﻣﻪﻠﻤﺟﺯﺍ .[4]
ﻪﺘﻔﻬﻧﻱﺮﮕﺷﺎﺧﺮﭘﺭﺎﭼﺩﻪﻛIBSﻪﺑﻥﺎﻳﻼﺘﺒﻣﺯﺍﻪﺘــﺳﺩﻥﺁﻪﻛ
ﻱﺮﮕﺷﺎﺧﺮﭘﻪﻛﻪﺘﺳﺩﻥﺁﺎﺑﻪﺴﻳﺎﻘﻣﺭﺩﺪﻨﺷﺎﺑﻰﻣﻪﻈﺣﻼﻣﻞﺑﺎﻗ
ﻥﻭﺪﺑ) ﻲﻳﺎﻬﻨﺗﻪﺑﻲﻧﺎﻣﺭﺩﻭﺭﺍﺩﻪﺑﺦــﺳﺎﭘﺭﺩ،ﺪﻧﺭﺍﺩﻒﻴﻔﺧﻪﺘﻔﻬﻧ
.[10] ﺪﻨﺘﺷﺍﺩﻱﺮﺗﺪﺑﻲﻬﮔﺁﺶﻴﭘ،(ﻰﻧﺎﻣﺭﺩﻥﺍﻭﺭ
ﻪــﺴﻳﺎﻘﻣﻑﺪﻫﺎﺑﻪﻌﻟﺎﻄﻣﻦﻳﺍ،ﻰﻠﺒﻗﺕﺎﻌﻟﺎﻄﻣﺞﻳﺎﺘﻧﻪﺑﻪﺟﻮﺗﺎﺑ
-ﻯﺭﺎﺘﻓﺭﻱﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﻭﻱﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻯﺎﻬﺷﻭﺭﻰﺸﺨﺑﺮﺛﺍ
ﻪﺑﻼﺘﺒﻣﺩﺍﺮﻓﺍﻥﺎﻣﺭﺩﻭﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳءﺎﻘﺗﺭﺍﺭﺩﻰﺘﺧﺎﻨﺷ
ﻪﻛﺩﻮﺑﻝﺍﻮﺳﻦﻳﺍﻪﺑﻰﻳﻮﮕﺨــﺳﺎﭘﺩﺪﺻﺭﺩﻭﺪــﺷﻡﺎﺠﻧﺍIBS
ﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻲﺘﺧﺎﻨــﺷ –ﻱﺭﺎﺘﻓﺭﻱﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺵﻭﺭﺎــﻳﺁ
ﻭﻢﺋﻼﻋﺩﻮﺒﻬﺑﺭﺩ،ﻲﻳﺎﻬﻨﺗﻪﺑﻲﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺯﺍﺶﻴﺑ،ﻱﺮﮕﻧﺎﻣﺭﺩ
؟ﺖﺳﺍﺮﺛﻮﻣIBSﻪﺑﻼﺘﺒﻣﻥﺍﺭﺎﻤﻴﺑﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳﺎﻘﺗﺭﺍ
ﺵﻭﺭ
ﻯﺭﺎﻣﺁﻪﻌﻣﺎﺟ .ﺖﺳﺍﻰﺑﺮﺠﺗﻪﺒــﺷﺕﺎﻌﻟﺎﻄﻣﻉﻮﻧﺯﺍﺶﻫﻭﮋﭘﻦﻳﺍﻪﻌﺟﺍﺮﻣﻰﺷﺭﺍﻮﮔﻝﻼﺘﺧﺍﻪﺑﻼﺘﺒﻣﻥﺍﺭﺎﻤﻴﺑﻪﻴﻠﻛﻞﻣﺎﺷﺶﻫﻭﮋﭘ
ﺎﺑﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍﻥﺎﻴﻣﺯﺍ .ﺩﻮــﺑﻰﺼﺼﺨﺗﻚﻴﻨﻴﻠﻛﻚﻳﻪﺑﻩﺪــﻨﻨﻛ
،ﻝﺎــﺳ 17-48 ﻦﻴﺑﻦــﺳ) ﻪﻌﻟﺎﻄﻣﻪﺑﺩﻭﺭﻭﻯﺎﻫﺭﺎﻴﻌﻣﻪﺑﻪﺟﻮﺗ
(ﺺﺨﺸﻣﺭﻮﻃﻪﺑﻰﻧﺎﻤﺴﺟﻭﻰﻧﺍﻭﺭﻯﺭﺎﻤﻴﺑﻪﻘﺑﺎــﺳﺩﻮﺟﻭﻡﺪﻋ
ﻯﺎﻬﻛﻼﻣﻭﺵﺭﺍﻮﮔﺺﺼﺨﺗﻕﻮﻓﻚﻳﻰﺑﺎﻳﺯﺭﺍﺯﺍﻩﺩﺎﻔﺘﺳﺍﺎﺑﻭ
ﺏﺎﺨﺘﻧﺍIBSﻪــﺑﻼﺘﺒﻣﺭﺎــﻤﻴﺑ 50 ،(ROME-II) ﻪﻣﺎﻨــﺸﺳﺮﭘ
.ﺪﻧﺪﻳﺩﺮﮔﻦــﻳﺰﮕﻳﺎﺟﻝﺮﺘﻨﻛﻭﺶــﻳﺎﻣﺯﺁﻩﻭﺮﮔﻭﺩﺭﺩﻭﺪﻧﺪــﺷ
ﻪﻣﺎﻨﺸﺳﺮﭘﺮﺑﻩﻭﻼﻋﺮﺿﺎﺣﺶﻫﻭﮋﭘﺭﺩﺎﻫﻩﺩﺍﺩﻱﺭﻭﺁﻊﻤﺟﻱﺍﺮﺑ
،ﻦــﺳ) ﻰﺘﺧﺎﻨــﺷﺖﻴﻌﻤﺟﺕﺎﻋﻼﻃﺍﻯﻭﺎﺣﻪﻛﻪﺘﺧﺎــﺳﻖﻘﺤﻣ
،ﻥﺎﻣﺭﺩﻪﻘﺑﺎــﺳ،ﻯﺭﺎﻤﻴﺑﻉﻮﻧ،ﺕﻼﻴﺼﺤﺗﻥﺍﺰﻴﻣ،ﻞﻐــﺷ،ﺲﻨﺟ
ﺮﻳﺯﻱﺎﻫﺭﺍﺰﺑﺍﺯﺍ،ﺩﻮﺑﺎﻬﻴﻧﺩﻮﻣﺯﺁ (ﻢﺋﻼﻋﺕﺪــﺷﻭﻥﺎﻣﺭﺩﻉﻭﺮــﺷ
.ﺪﺷﻩﺩﺎﻔﺘﺳﺍ
:(IBSﻢﺋﻼﻋﺺﺧﺎـﺷ) ROME-IIﻪﻣﺎﻨـﺸﺳﺮﭘ (ﻒﻟﺍ
ﺩﻮﺟﻭﻡﺪﻋﺎﻳﺩﻮﺟﻭﻪﻛﺖــﺳﺍﻰﺗﻻﺍﻮﺳﻞﻣﺎﺷﻪﻣﺎﻨــﺸﺳﺮﭘﻦﻳﺍ
ﻦﻳﺍﺭﺩﻻﺎﺑﻩﺮﻤﻧ [11] .ﺪﺠﻨــﺳﻰﻣﺍﺭIBSﻯﺭﺎﻤﻴﺑﻯﺎﻫﻪﻧﺎــﺸﻧ
ﻞﻣﺎﺷﻪﻣﺎﻨﺸﺳﺮﭘﻦﻳﺍ .ﺖﺳﺍﻯﺭﺎﻤﻴﺑﺕﺪﺷﻩﺪﻨﻫﺩﻥﺎﺸﻧﺱﺎﻴﻘﻣ
ﺏﺍﻮﺟﺮﻫﻯﺍﺯﺍﺭﺩﺭﺎﻤﻴﺑﻪﻛﺖﺳﺍﺮﻴﺧﺎﻳﻰﻠﺑﺦﺳﺎﭘﺎﺑﻝﺍﻮﺳ 14
ﻩﺮﻤﻧﻚﻳ،ﺩﻮﺷﻰﻣﺪﻴﻳﺎﺗﺺﺼﺨﺘﻣﻚــﺷﺰﭘﻂــﺳﻮﺗﻪﻛﺖﺒﺜﻣ
ﺪﻨﭼﺕﺭﻮﺻﻪﺑًﺍﺮــﺜﻛﺍﺕﻻﺍﻮــﺳﻪﻴﻘﺑﻭﺪﻨﻛﻰﻣﺖﻓﺎﻳﺭﺩﺖــﺒﺜﻣ
ﺪﻴﻳﺎﺗﺍﺭIBSﻪﻛﺹﺎﺧﻪﻨﻳﺰﮔﻚﻳﻯﺍﺯﺍﺭﺩﻪﻛﺖﺳﺍﻯﺍﻪﻨﻳﺰﮔ
ﺖﺒﺜﻣﺕﺍﺮﻤﻧﻥﺎﻳﺎﭘﺭﺩ .ﺪــﻨﻛﻰﻣﺖﻓﺎﻳﺭﺩﻩﺮﻤﻧﻚﻳﺭﺎــﻤﻴﺑﺪﻨﻛ
ﻯﺭﺎﻤﻴﺑﺕﺪــﺷﻥﺍﺰﻴﻣﻭﻊﻤﺟﺕﻻﺍﻮــﺳﻪﻋﻮﻤﺠﻣﻚﻳﺭﺩﺭﺎﻤﻴﺑ
ﻯﺎﻬﻛﻼﻣﺪــﺷﺎﺑﺮﺗﻻﺎﺑﻩﺮﻤﻧﻦﻳﺍﺭﺪﻗﺮﻫ .ﺩﺩﺮﮔﻰﻣﻦــﻴﻴﻌﺗﻯﻭ
ﺖﺳﺍﺮﻛﺫﻪﺑﻡﺯﻻ .ﺩﻮﺑﺪﻫﺍﻮﺧﺮﺘﺸﻴﺑﻯﺭﺎﻤﻴﺑﻊﻔﻧﻪﺑﻰﺼﻴﺨﺸﺗ
ﺵﺭﺍﻮﮔﺺﺼﺨﺘﻣﻚــﺷﺰﭘﻂﺳﻮﺗROM-IIﻪﻣﺎﻨــﺸﺳﺮﭘﻪﻛ
.ﺪﻳﺩﺮﮔﻞﻴﻤﻜﺗﻪﻨﻳﺎﻌﻣ
90 ﻞﻣﺎﺷﻪﻣﺎﻨــﺸﺳﺮﭘﻦﻳﺍ :SCL-90-Rﻪﻣﺎﻨـﺸﺳﺮﭘ (ﺏ
ﻒﻠﺘﺨﻣﺪﻌﺑ 9 ﻭﺖﺳﺍﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭﻢﺋﻼﻋﻰﺑﺎﻴﺷﺯﺭﺍﻯﺍﺮﺑﻝﺍﻮﺳ
ﻂﺑﺍﻭﺭﺭﺩﺖﻴﺳﺎﺴﺣ،ﻱﺭﺎﺒﺟﺍ - ﻲــﺳﺍﻮﺳﻭ،ﻰﻧﺎﻤﺴﺟﺕﺎﻳﺎﻜــﺷ
ﺭﺎﻜﻓﺍ،ﻰﺿﺮﻣﺱﺮﺗ،ﻯﺮﮕﺷﺎﺧﺮﭘ،ﺏﺍﺮﻄﺿﺍ،ﻰﮔﺩﺮﺴﻓﺍ،ﻞﺑﺎﻘﺘﻣ ﻯﺭﺍﺬﮔﻩﺮﻤﻧ .ﺩﺮﻴﮔﻰﻣﺮــﺑﺭﺩﺍﺭﻰﮕﺘــﺴﺴﮔﻥﺍﻭﺭﻭﻯﺪﻴﺋﻮﻧﺍﺭﺎﭘ
ﻢﺋﻼﻋﻰﻠﻛﺐﻳﺮﺿﺺﺧﺎﺷﻪﺳﺱﺎﺳﺍﺮﺑﻪﻣﺎﻨﺸﺳﺮﭘﺮﻴــﺴﻔﺗﻭ
ﺖــﺳﺪﺑﻰﺿﺮﻣﻢﺋﻼﻋﻊﻤﺟﻭﻰﺘﺣﺍﺭﺎﻧﺐﻳﺮﺿﺭﺎﻴﻌﻣ،ﻰــﺿﺮﻣ
ﻱﻭﻮﻛﻭﻦﻤﭙﻴﻟ،ﺲﺘﻳﻮﮔﺍﺭﺩﻂﺳﻮﺗﻪﻣﺎﻨﺸﺳﺮﭘﻪﻴﻟﻭﺍﻡﺮﻓ .ﺪﻳﺁﻰﻣ
ﺖﻓﺮﮔﺭﺍﺮﻗﺮﻈﻧﺪﻳﺪﺠﺗﺩﺭﻮﻣ 1983 ﻝﺎﺳﺭﺩﻭ .[12] ﺪﺷﻲﻓﺮﻌﻣ
0/36 ﻦﻴﺑﻥﺁﻲﺋﺍﻭﺭﻭ 0/90 ﺎﺗ 0/72 ﻦﻴﺑﻪﻣﺎﻨﺸﺳﺮﭘﻦﻳﺍﺭﺎﺒﺘﻋﺍ
ﻭﻲﮔﮋﻳﻭ،ﺖﻴــﺳﺎﺴﺣﻩﻭﻼﻋﻪﺑ .ﺖــﺳﺍﻩﺪــﺷﺵﺭﺍﺰﮔ 0/73 ﺎﺗ
،0/94 ﺎﺑﺮﺑﺍﺮﺑﺐــﻴﺗﺮﺗﻪﺑﻭﻻﺎﺑﺭﺎﺒﺘﻋﺍﺎــﺑﻥﻮﻣﺯﺁﻦﻳﺍﻲــﻳﺁﺭﺎﻛ
.[14ﻭ13] ﺖﺳﺍﻩﺪﺷﺵﺭﺍﺰﮔ 0/96 ﻭ 0/98
ﻲﺘﺧﺎﻨــﺷ - ﻱﺭﺎﺘﻓﺭﻱﺮــﮕﻧﺎﻣﺭﺩ :ﻯﺮـﮕﻧﺎﻣﺭﺩﻩﻮﻴـﺷ (ﺝ
ﻲﭘﺭﺩﻲﭘﺔــﺴﻠﺟﺖــﺸﻫﻰﻃﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻱﺍﺮــﺑ (CBT)
ﻡﺎﺠﻧﺍﻩﺎﻣﻭﺩﻝﻮــﻃﺭﺩًﺍﺩﻭﺪﺣﻭﻪــﺴﻠﺟﻚﻳﻱﺍﻪﺘﻔﻫ،ﻲﻧﺎﻣﺭﺩ
ﻥﺍﺭﺎﻤﻴﺑ،ﺵﺭﺍﻮﮔﺺﺼﺨﺘﻣﺭﻮﺘﺳﺩﻖﺑﺎﻄﻣﻥﺁﺎﺑﻩﺍﺮﻤﻫﻭﺪــﺷ
.ﺪﻧﺩﺮﻛﻰﻣﻑﺮﺼﻣﺍﺭﻩﺪﺷﺰﻳﻮﺠﺗﻯﺎﻫﻭﺭﺍﺩ
ﻚــﺷﺰﭘﻥﺎﻤﻫﻂــﺳﻮﺗﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺖﺤﺗﻂﻘﻓﻝﺮﺘﻨﻛﻩﻭﺮﮔ
ﻝﻮﻃﺭﺩﺍﺭﻰﻧﺎﺴﻜﻳﻯﺎﻫﻭﺭﺍﺩﺰﻴﻧﺎﻬﻧﺁ .ﺪﻧﺩﻮﺑﺵﺭﺍﻮﮔﺺﺼﺨﺘﻣ
ﻭﺩﺲﭙﺳ .ﺪﻧﺩﻮﻤﻧﺖﻓﺎﻳﺭﺩﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﺎﺑﻪﺑﺎــﺸﻣﻥﺎﻣﺯﺕﺪﻣ
ﺖﻬﺟﺯﺍﻢﻫ،ﻥﺎــﻣﺭﺩﻩﺎﻣ 2 ﺯﺍﺲــﭘﻝﺮﺘﻨﻛﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮــﮔ
ﺩﺭﻮﻣﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄــﺳﺖﻬﺟﺯﺍﻢﻫﻭIBSﻢﺋﻼﻋﺶﻫﺎﻛ
.ﺪﻨﺘﻓﺮﮔﺭﺍﺮﻗﻰﺑﺎﻳﺯﺭﺍ
،ﻦﻴﮕﻧﺎﻴﻣ،ﺪﺻﺭﺩ،ﻰﻧﺍﻭﺍﺮﻓﺵﻭﺭﺯﺍﺎﻫﻩﺩﺍﺩﻞﻴﻠﺤﺗﻭﻪﻳﺰﺠﺗﻯﺍﺮﺑ
.ﺪﺷﻩﺩﺎﻔﺘﺳﺍtﻥﻮﻣﺯﺁ
ﺎﻫ
ﻪﺘﻓﺎﻳ
36) ﺮﻔﻧ 18 ،ﻝﺎﺳ 26 ﺎﺗ 17 ﻰﻨــﺳﻩﻭﺮﮔﺭﺩ (ﺪﺻﺭﺩ 42) ﺮﻔﻧ21
ﺭﺩ (ﺪﺻﺭﺩ 22) ﺮﻔﻧ11 ﻭﻝﺎﺳ 36 ﺎﺗ 27 ﻰﻨــﺳﻩﻭﺮﮔﺭﺩ (ﺪﺻﺭﺩ
،ﺕﻼﻴﺼﺤﺗﺢﻄﺳﻦﻳﺮﺘﺸﻴﺑ .ﺪﻧﺩﻮﺑﻝﺎﺳ 46 ﺎﺗ 37 ﻰﻨــﺳﻩﻭﺮﮔ
ﺪﺻﺭﺩ 22 ﺎﺑﺲﻧﺎــﺴﻴﻟﻥﺁﺯﺍﺪﻌﺑﻭﻰﻧﺍﻭﺍﺮﻓﺪﺻﺭﺩ 40 ﺎﺑﻢﻠﭙﻳﺩ
.ﺩﻮﺑ
ﺱﺎﻴﻘﻣﺭﺩﻩﻭﺮــﮔﻭﺩﻯﺎﻫﻰﻧﺩﻮﻣﺯﺁﺕﺍﺮــﻤﻧﻲــﺳﺭﺮﺑﺭﻮﻈﻨﻣﻪﺑ
ﻥﻮﻣﺯﺁﺯﺍﻥﻮﻣﺯﺁﺲﭘﻭﻥﻮــﻣﺯﺁﺶﻴﭘﻪــﻠﺣﺮﻣﻭﺩﺭﺩRom-١١
ﻪﻠﺣﺮﻣﺭﺩ،ﺩﺍﺩﻥﺎﺸﻧﻩﺪﻣﺁﺖﺳﺪﺑﺞﻳﺎﺘﻧ .ﺪﺷﻩﺩﺎﻔﺘﺳﺍﻞﻘﺘــﺴﻣt
ﺕﻭﺎﻔﺗﻦﻳﺍﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣﺭﺩﻰﻟﻭ .ﺩﻮﺒﻧﺭﺍﺩﺎــﻨﻌﻣRom-١١
ﻥﺍﻭﺭﻪﻛﻰﻫﻭﺮﮔﻰﻨﻌﻳ .ﺩﻮﺑﺭﺍﺩﻰﻨﻌﻣ (P< 0/001) ﺢﻄــﺳﺭﺩ
ﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮــﻤﻫﻪﺑﺍﺭﻰﺘﺧﺎﻨــﺷ –ﻯﺭﺎﺘﻓﺭﻯﺮــﮕﻧﺎﻣﺭﺩ
ﻦﻳﺍﺭﺩﻯﺮﺘﻤﻛﺕﺍﺮﻤﻧﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣﺭﺩ،ﺪــﻧﺩﻮﻤﻧﺖﻓﺎﻳﺭﺩ
ﺎﻫﻰﻧﺩﻮﻣﺯﺁﺕﺍﺮﻤﻧﻞﺿﺎﻔﺗ،ﻦﻳﺍﺮﺑﻩﻭﻼﻋ .ﺪﻧﺩﺮﻛﺐﺴﻛﺱﺎﻴﻘﻣ
ﺪﻳﺩﺮﮔﻪﺒﺳﺎﺤﻣﻩﻭﺮﮔﻭﺩﺮﻫﻯﺍﺮﺑﻥﻮﻣﺯﺁﺲﭘﻭﻥﻮﻣﺯﺁﺶﻴﭘﺭﺩ
ﻰﻨﻌﻣ (P< 0/001) ﺢﻄﺳﺭﺩﻩﻭﺮﮔﻭﺩﻯﺎﻫﻦﻴﮕﻧﺎﻴﻣﻞﺿﺎﻔﺗﻪﻛ
ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺮــﻴﺛﺎﺗﺩﺍﺩﻥﺎــﺸﻧﻪﺠﻴﺘﻧﻦﻳﺍ .ﺩﻮــﺑﺭﺍﺩ IBSﻝﻼﺘﺧﺍﻥﺎﻣﺭﺩﺭﺩﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻰﺘﺧﺎﻨــﺷ –
.(1ﻝﻭﺪﺟ)ﺖﺳﺍﺮﺛﻮﻣﻰﻳﺎﻬﻨﺗﻪﺑﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﺯﺍﺮﺘﺸﻴﺑ
ﻱﺎﻬﺳﺎﻴﻘﻣﻩﺩﺮﺧﺭﺩﻩﻭﺮﮔﻭﺩﻯﺎﻬﻴﻧﺩﻮﻣﺯﺁﻩﺮﻤﻧﻲﺳﺭﺮﺑﺭﻮﻈﻨﻣﻪﺑ
ﺶﻴﭘﻪﻠﺣﺮﻣﺭﺩﻲﺿﺮﻣﻢــﺋﻼﻋﻲﻠﻛﺺﺧﺎــﺷﻭSCL-90-R
.ﺪﻣﺁﻞﻤﻋﻪﺑﻩﺩﺎﻔﺘﺳﺍﻞﻘﺘــﺴﻣtﻥﻮﻣﺯﺁﺯﺍﻥﻮﻣﺯﺁﺲﭘﻭﻥﻮﻣﺯﺁ
ﺶﻴﭘﻪﻠﺣﺮﻣﺭﺩﺩﻮــﺷﻲﻣﻪﻈﺣﻼﻣ 2 ﻝﻭﺪﺟﺭﺩﻪــﻛﺭﻮــﻄﻧﺎﻤﻫ
ﻩﺩﺮﺧﺯﺍﻚﻴﭽﻴﻫﺭﺩﻝﺮﺘﻨﻛﻩﻭﺮﮔﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻦﻴﺑﻥﻮــﻣﺯﺁ
ﺭﺩﻲﻟﻭﺩﺭﺍﺪﻧﺩﻮﺟﻭﺭﺍﺩﺎﻨﻌﻣﺕﻭﺎــﻔﺗSCL-90-Rﻱﺎﻫﺱﺎﻴﻘﻣ
ﻪﻤﻫﺭﺩﻝﺮﺘﻨﻛﻩﻭﺮﮔﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻭﺩﻦﻴﺑﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣ
(P< 0/001) ﺭﺍﺩﺎﻨﻌﻣﺕﻭﺎﻔﺗSCL-90-Rﻱﺎــﻫﺱﺎﻴﻘﻣﻩﺩﺮﺧ
.(3ﻝﻭﺪﺟ)ﺩﺭﺍﺩﺩﻮﺟﻭ
ﺚﺤﺑ
ﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺵﻭﺭﻪــﻛﺩﺍﺩﻥﺎــﺸﻧﺶــﻫﻭﮋﭘﻦﻳﺍﺞــﻳﺎﺘﻧﻥﺎﻣﺭﺩﺯﺍﺶﻴﺑ،ﻯﺮــﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭ
ﻝﺮﺘﻨﻛﻩﻭﺮﮔ .ﺩﻮﺑﺮﺛﻮﻣIBSﻢﺋﻼﻋﺩﻮﺒﻬﺑﺭﺩﻰﻳﺎﻬﻨﺗﻪﺑﻰﻳﻭﺭﺍﺩ
ﺍﺭIBSﻢﺋﻼﻋﺶﻫﺎﻛ،ﺪــﻧﺩﻮﺑﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺖــﺤﺗﻂﻘﻓﻪﻛ ﻩﻭﺮﮔﻰﻓﺮﻃﺯﺍ .ﺩﻮﺒﻧﻪــﺟﻮﺗﻞﺑﺎﻗﺶﻫﺎﻛﻦﻳﺍﺎﻣﺍ،ﺪﻧﺩﺍﺩﻥﺎــﺸﻧ
ﻢﺋﻼﻋﻭﺪﻧﺩﺍﺩﺦــﺳﺎﭘﻥﺎﻣﺭﺩﻪﺑﻝﺮﺘﻨﻛﻩﻭﺮﮔﺯﺍﺶﻴﺑﺶــﻳﺎﻣﺯﺁ
ﻪﻛﻰﻧﺍﺭﺎﻤﻴﺑﺮــﮕﻳﺩﺕﺭﺎﺒﻋﻪﺑ .ﺖﻓﺎﻳﺶﻫﺎﻛﺎــﻬﻧﺁﺭﺩﻯﺭﺎــﻤﻴﺑ
ﻪﺑﻰﺘﺧﺎﻨــﺷ –ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭ) ﻰﺒﻴﻛﺮﺗﻥﺎﻣﺭﺩﺖﺤﺗ ROMIIﻰﻨﻴﻟﺎﺑﺺﺧﺎــﺷﺭﺩﺪﻧﺍﻩﺩﻮﺑ (ﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮــﻤﻫ
ﻒﻴﻔﺨﺗﻩﺪﻨﻫﺩﻥﺎﺸﻧﻦﻳﺍﻪﻛﺪﻧﺍﻩﺩﻮﻤﻧﺐــﺴﻛﺍﺭﺮﺘﻤﻛﺕﺍﺮﻤﻧ
ﺎﻬﻨﺗﻪﻧﻥﺍﺭﺎﻤﻴﺑﻦــﻳﺍ .ﺖــﺳﺍﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍﺭﺩIBSﻯﺎﻫﻪﻧﺎــﺸﻧ
ﻪﺴﻳﺎﻘﻣﺭﺩﻪﻜﻠﺑﺪﻧﺍﻪﺘﻓﺎﻳﺮﺘﺸﻴﺑﻯﺩﻮﺒﻬﺑﻝﺮﺘﻨﻛﻩﻭﺮﮔﻪﺑﺖﺒﺴﻧ
ﻯﺮﺗﻦﻴﻳﺎﭘﺕﺍﺮــﻤﻧﺯﺍﻥﻮﻣﺯﺁﺶﻴﭘﻪﻠﺣﺮﻣﺭﺩﺰــﻴﻧﻥﺎــﺷﺩﻮﺧﺎﺑ
ﻥﺩﻮﺑﻦﻴﻳﺎﭘ .ﺪــﻧﺩﻮﺑﺭﺍﺩﺭﻮــﺧﺮﺑROMIIﻰــﻨﻴﻟﺎﺑﺺﺧﺎــﺷﺭﺩ
ﻡﺎﺠﻧﺍﺕﺎﻘﻴﻘﺤﺗﺯﺍﻰﺧﺮﺑﺎﺑﻪﻠﺣﺮﻣﻦﻳﺍﺭﺩﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﺕﺍﺮــﻤﻧ
ﺪﻨﻧﺁﺮﮕﻧﺎﻴﺑﺕﺎﻘﻴﻘﺤﺗﻦﻳﺍ .[7ﻭ11-15] ﺪــﺷﺎﺑﻰﻣﻮﺴﻤﻫﻩﺪــﺷ
ﻥﺎﻣﺭﺩﻭﺕﺪﻣﻩﺎﺗﻮﻛﻯﺮــﮔﻞﻴﻠﺤﺗﻥﺍﻭﺭ،ﻰﻧﺎﻣﺭﺩﺖﺧﺎﻨــﺷﻪﻛ
.ﺪﻧﺍﻩﺩﻮﺑIBSﻯﺍﺮﺑﻰﻧﺎﻣﺭﺩﺵﻭﺭﻦﻳﺮﺘﻳﻮﻗﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭ
ﺯﺍ %80 ﺩﻮﺒﻬﺑﺐﺒﺳﻰﻳﻭﺭﺍﺩﻭﻰﺘﺧﺎﻨﺷﻥﺎﻣﺭﺩ،ﻪﺴﻳﺎﻘﻣﻚﻳﺭﺩ
ﺯﺍﻯﺮﺗﻊﻴﺳﻭﺶﻫﺎﻛﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭﻥﺎﻣﺭﺩﺭﺩﻭﺪﺷIBSﻥﺍﺭﺎﻤﻴﺑ
ﻚﻳﺭﺩﻰﺘﺧﺎﻨﺸﻧﺍﻭﺭﻥﺎﻣﺭﺩﻯﺎﻳﺍﺰﻣﻩﻭﻼﻌﺑ .ﺪﻧﺩﺍﺩﻥﺎﺸﻧﺍﺭﻢﺋﻼﻋ
ﻭ [16] ﻮﺘﻨﻴﭘ .[15] ﺪﻧﺪﻧﺎﻣ ﻰﻗﺎﺑﺰﻴﻧﻥﺎﻣﺭﺩﺯﺍﺪﻌﺑﻰﻧﻻﻮﻃﻩﺭﻭﺩ
ﻥﺎﻣﺭﺩﻭﻲﺘﺧﺎﻨﺷﺯﺎﺑﻪﻛﺪﻨﺘﻓﺎﻳﺖــﺳﺩﻪﺠﻴﺘﻧﻦﻳﺍﻪﺑﻥﺍﺭﺎﻜﻤﻫ
ﻩﺩﺮــﺴﻓﺍﻭﺏﺮﻄﻀﻣﻱﺎﻬﻫﻭﺮﮔﺮﻳﺯﺭﺩﻲﮔﺩﺮــﺴﻓﺍﻭﺏﺍﺮﻄﺿﺍ
ﻲﺑﺎﻴﺘــﺳﺩﺖﻬﺟﻲﻧﺎﻣﺭﺩﺭﺎﺘﻓﺭﻭﻥﺍﺩﺮﮔﻥﺍﻭﺭﻱﺎﻫﻭﺭﺍﺩﺎﺑIBS IBSﻥﺎﻣﺭﺩﺭﺩﺪﻧﺍﻮﺗﻰﻣﺖﺒﺜﻣﻱﺍﻪﻠﺑﺎﻘﻣﻱﺎﻬﺗﺭﺎﻬﻣﻪﺑﺮﺘــﺸﻴﺑ
ﺩﺍﺮﻓﺍﻪﻛﺖــﺳﺍﻦﻳﺍﻪﺟﻮﺗﻞﺑﺎﻗﻉﻮﺿﻮﻣ .ﺩﺮﻴﮔﺭﺍﺮﻗﻪﺟﻮﺗﺩﺭﻮــﻣ
ﻰﺘﺧﺎﻨــﺷﻥﺍﻭﺭﻥﺎﻣﺭﺩ،ﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺎﺑﻩﺍﺮــﻤﻫﻰﺘﻗﻭ،ﻼــﺘﺒﻣ
ﻯﺭﺎﻤﻴﺑﻯﺎﻫﻪﻧﺎﺸﻧﺪــﺳﺭﻰﻣﺮﻈﻧﻪﺑ،ﺪﻧﺭﺍﺩﻰﻣﺖﻓﺎﻳﺭﺩ (CBT)
ﺎﻬﻧﺁﻞﺿﺎﻔﺗﻭﻥﻮﻣﺯﺁﺲﭘ،ﻥﻮﻣﺯﺁﺶﻴﭘﻪﻠﺣﺮﻣﺭﺩﻩﻭﺮﮔﻭﺩﺭﺩ Rom-11 ﺕﺍﺮﻤﻧﻯﺍﺮﺑtﻥﻮﻣﺯﺁﺞﻳﺎﺘﻧ -1 ﻝﻭﺪﺟ
ﻞﺣﺍﺮﻣ
ﺎﻬﻫﻭﺮﮔ ﻦﻴﮕﻧﺎﻴﻣ
ﻑﺍﺮﺤﻧﺍ
ﺭﺎﻴﻌﻣ ﻦﻳﻮﻟﻥﻮﻣﺯﺁ
t
ﻱﺩﺍﺯﺁﻪﺟﺭﺩ ﻱﺭﺍﺩﺎﻨﻌﻣﺢﻄﺳ
Fﺖﺒﺴﻧ
ﻱﺭﺍﺩﺎﻨﻌﻣﺢﻄﺳ
ﻥﻮﻣﺯﺁﺶﻴﭘ ﺶﻳﺎﻣﺯﺁ
10/85 2/13
1/238 0/271
0/089 48
0/93
ﻝﺮﺘﻨﻛ
10/8 1/78
ﻥﻮﻣﺯﺁﺲﭘ ﺶﻳﺎﻣﺯﺁ
4 1/83
2/527 0/118
6/9 48
0/001
ﻝﺮﺘﻨﻛ
8/1 2/24
ﻥﻮﻣﺯﺁﺶﻴﭘﻞﺿﺎﻔﺗ ﻥﻮﻣﺯﺁﺲﭘﻭ ﺶﻳﺎﻣﺯﺁ
6/85 3/0
1/672 0/202
6/86 48
0/001
ﻝﺮﺘﻨﻛ
ﻪﻜﻧﺎﻨﭼ .ﺪﻨﻛﻰﻣﺍﺪﻴﭘﻯﺍﻪــﻈﺣﻼﻣﻞﺑﺎﻗﺶﻫﺎﻛﺎــﻬﻧﺁﺭﺩIBS
ﻲﻧﺎﻣﺭﺩﻥﺍﻭﺭﺩﺍﺩﻥﺎــﺸﻧ [17] ﻥﺍﺭﺎﻜﻤﻫﻭﻯﺮﺗﺎﮔﻖﻴﻘﺤﺗﺞﻳﺎﺘﻧ
ﺖﺳﻮﺒﻳﺎﻣﺍ،ﺪﺷﻝﺎﻬﺳﺍﻭﻲﻤﻜﺷﺩﺭﺩﺶﻫﺎﻛﺚﻋﺎﺑ،ﻥﺍﺭﺎﻤﻴﺑﺭﺩ
ﻥﺎﺸﻧﻲﺘﺧﺎﻨﺷﻥﺎﻣﺭﺩ .ﺖــﺷﺍﺪﻧﻰﻧﺍﺪﻨﭼﺩﻮﺒﻬﺑ،ﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍﺭﺩ
ﻦﻴﻨﭽﻤﻫ .ﺪــﺷﺎﺑﺮﺛﻮﻣIBSﻱﺭﺎﻤﻴﺑﻝﺮﺘﻨﻛﺭﺩﺪﻧﺍﻮﺗﻰﻣﻪﻛﺩﺍﺩ
ﻥﺩﺮﻛﻞــﺷﺵﺯﻮﻣﺁ،ﺪﻧﺩﺮﻛﻥﺎﻴﺑ [18] ﻥﺍﺭﺎﻜــﻤﻫﻭﺩﺭﺎﭽﻧﻼﺑ
ﺐﺒــﺳﺶﻣﺍﺭﺁﺩﺎﺠﻳﺍﻭﻰﮔﺪﻴﻨﺗﺶﻫﺎﻛﺵﺯﻮﻣﺁﻭﻥﺪﺑﺕﻼﻀﻋ
ﺕﺭﻮﺻﻪﺑﺎﻬﺷﻭﺭﻦﻳﺍﻲﺘﻗﻭﻭﺪﻧﻮــﺷﻰﻣﻱﺭﺎﻤﻴﺑﻢﺋﻼﻋﺶﻫﺎﻛ
%50 ﺩﻭﺪﺣﺭﺩﺪﻧﻮﺷﻩﺩﺎﻔﺘــﺳﺍﻝﺎــﺳ 4 ﻲﻃﺭﺩﻭﺕﺪﻣﻲﻧﻻﻮﻃ
.ﺪﻧﻮﺷﻰﻣﻥﺎﻣﺭﺩﻢﻜــﺷﺦﻔﻧ ،ﻉﻮﻬﺗ ،ﺩﺭﺩﻞﺜﻣﻱﺭﺎﻤﻴﺑﻢﺋﻼﻋﺯﺍ IBSﻢﺋﻼﻋﺯﺍﻰــﺧﺮﺑﺪﻧﺍﻩﺩﺍﺩﻥﺎــﺸﻧﺮﻛﺬﻟﺍﻕﻮﻓﻯﺎﻬــﺸﻫﻭﮋﭘ
.ﺩﺮﻴﮔﻰﻣﺭﺍﺮﻗﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺮﻴﺛﺎﺗﺖﺤﺗﺮﮕﻳﺩﻢﺋﻼﻋﺯﺍﺮﺘﺸﻴﺑ ROMIIﺺﺧﺎــﺷﺭﺩﻥﺍﺭﺎﻤﻴﺑﺕﺍﺮﻤﻧﺰﻴﻧﺮﺿﺎﺣﺶــﻫﻭﮋﭘﺭﺩ
ﺎﺑﺮﺿﺎﺣﻖﻴﻘﺤﺗ .ﺖــﺳﺍﻪﺘﻓﺎﻳﺶﻫﺎﻛﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺯﺍﺲــﭘ ﺪﻧﺪﻘﺘﻌﻣﺎﻬﻧﺁ .ﺖــﺳﺍﺮﻳﺎﻐﻣ [6] ﺖــﺴﻳﺭﺎﻜﻠﻴﮔﻭﺲﻳﻮﺑﻖــﻴﻘﺤﺗ
ﻰﺷﺎﻧﻰﻧﺍﻮﺗﺎﻧﻭﺎﻬﻴﻧﺎﺸﻳﺮﭘ،ﻰﺘﺧﺎﻨﺷ - ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭ
ﻯﺎﻫﻪﻧﺎــﺸﻧﻰﻧﺍﻭﺍﺮﻓﺯﺍﺎﻣﺍ،ﺪﻫﺩﻰﻣﺶﻫﺎﻛﺍﺭIBSﻢــﺋﻼﻋﺯﺍ
ﻥﺎﻣﺭﺩﻪﻛﺖــﺳﺍﻥﺁﺮﮕﻧﺎﻴﺑﺐﻠﻄﻣﻦــﻳﺍ .ﺪــﻫﺎﻛﻰﻤﻧﻯﺍﻩﺩﻭﺭ
،ﻰﺘﺧﺎﻨﺷﺦﺳﺎﭘﺮﻴﻴﻐﺗﻖﻳﺮﻃﺯﺍًﻻﺎﻤﺘﺣﺍIBSﻰﺘﺧﺎﻨﺷ - ﻯﺭﺎﺘﻓﺭ
.ﺩﺭﺍﺬﮔﻰﻣﺮﻴﺛﺎﺗﻰﻳﺎﺸﺣﺍﺖﻴﺳﺎﺴﺣﺶﻳﺍﺰﻓﺍﺮﺑ
ﻰﺘﻗﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻪﻛﺖﺳﺍﻩﺩﺍﺩﻥﺎــﺸﻧﺮﺿﺎﺣﺶﻫﻭﮋﭘﺞﻳﺎﺘﻧ
ﻥﺍﺭﺎﻤﻴﺑﻯﺍﺮﺑﻪــﻛﻰﺼﺨــﺸﻣﻯﺎﻫﻭﺭﺍﺩ) ﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺖﺤﺗ
ﻥﺍﻭﺭﻥﺎــﻣﺰﻤﻫﻭﺪﻧﺮﻴﮔﻰﻣﺭﺍﺮــﻗ (ﺪﻧﻮــﺷﻰﻣﺺﺨــﺸﻣIBS
ﻦﻳﺍﻪﻜﻧﺁﻞﻴﻟﺩﻪﺑﺪــﻧﺭﺍﺩﻰﻣﺖﻓﺎﻳﺭﺩﻰﺘﺧﺎﻨــﺷﻯﺭﺎﺘﻓﺭﻰﻧﺎﻣﺭﺩ
،ﺩﺩﺮﮔﻰﻣﻝﺎﻤﻋﺍﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍﻯﺍﺮﺑﻰﺒﻴﻛﺮﺗﺕﺭﻮﺻﻪﺑﺵﻭﺭﻭﺩ
ﺭﺍﺮﻗﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺖــﺤﺗﻂﻘﻓﻪﻜﻧﺁﺯﺍﺶﻴﺑﺪــﺳﺭﻰﻣﺮﻈﻧﻪﺑ
.ﺪﺑﺎﻳﻰﻣﺶﻫﺎﻛﺎﻬﻧﺁﺭﺩIBSﻢﺋﻼﻋ (ﻝﺮﺘﻨﻛﻩﻭﺮﮔ) ﺪﻨﺷﺎﺑﻪﺘﻓﺮﮔ CBTﻭﻰﻳﻭﺭﺍﺩﻥﺎﻣﺭﺩﺵﻭﺭﻭﺩﺪﺳﺭﻰﻣﺮﻈﻧﻪﺑﻪﻛﻦﻳﺍﻪﺠﻴﺘﻧ
ﻥﻮﻣﺯﺁﺶﻴﭘﻪﻠﺣﺮﻣﺭﺩﻝﺮﺘﻨﻛﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻭﺩﻦﻴﺑSCL-90-Rﻥﻮﻣﺯﺁﻱﺎﻬﺳﺎﻴﻘﻣﻩﺩﺮﺧﻱﺭﺎﻣﺁﻱﺎﻫﺺﺧﺎﺷﻪﺴﻳﺎﻘﻣ -2ﻝﻭﺪﺟ
SCL-90-Rﻱﺎﻬﺳﺎﻴﻘﻣ ﻩﻭﺮﮔﻭﺩ ﻦﻴﮕﻧﺎﻴﻣ ﺭﺎﻴﻌﻣﻑﺍﺮﺤﻧﺍ tﺭﺍﺪﻘﻣ ﻯﺩﺍﺯﺁﻪﺟﺭﺩ ﻯﺭﺍﺩﺎﻨﻌﻣﺢﻄﺳ ﻲﻧﺎﻤﺴﺟﺖﻳﺎﻜﺷ ﺶﻳﺎﻣﺯﺁ 1,62 0,98 0,149 48 0,88 ﻝﺮﺘﻨﻛ 1,65 0,78 ﺭﺎﺒﺟﺍﻭﺱﺍﻮﺳﻭ ﺶﻳﺎﻣﺯﺁ 1,74 0,80 0,022 48 0,98 ﻝﺮﺘﻨﻛ 1,74 0,79 ﻞﺑﺎﻘﺘﻣﻂﺑﺍﻭﺭﺭﺩﺖﻴﺳﺎﺴﺣ ﺶﻳﺎﻣﺯﺁ 1,57 0,73 0,849 48 0,40 ﻝﺮﺘﻨﻛ 1,38 0,72 ﻲﮔﺩﺮﺴﻓﺍ ﺶﻳﺎﻣﺯﺁ 2,01 0,64 1,82 48 0,07 ﻝﺮﺘﻨﻛ 1,56 0,98 ﺏﺍﺮﻄﺿﺍ ﺶﻳﺎﻣﺯﺁ 1,59 0,96 0,21 48 0,83 ﻝﺮﺘﻨﻛ 1,53 0,92 ﻱﺮﮕﺷﺎﺧﺮﭘ ﺶﻳﺎﻣﺯﺁ 1,55 0,83 0,17 48 0,86 ﻝﺮﺘﻨﻛ 1,60 1,09 ﻲﺿﺮﻣﺱﺮﺗ ﺶﻳﺎﻣﺯﺁ 0,97 0,70 0,29 48 0,77 ﻝﺮﺘﻨﻛ 0,91 0,79 ﻱﺪﻴﺋﻮﻧﺍﺭﺎﭘﺭﺎﻜﻓﺍ ﺶﻳﺎﻣﺯﺁ 1,86 0,81 1,51 48 0,13 ﻝﺮﺘﻨﻛ 1,48 0,91 ﻰﮕﺘﺴﺴﮔﻥﺍﻭﺭ ﺶﻳﺎﻣﺯﺁ 1,40 0,69 1,30 48 0,19 ﻝﺮﺘﻨﻛ 1,16 0,58
ﺹﻮﺼﺧﺭﺩﺍﺭﻯﺮﺘﻬﺑﻰﻬﮔﺁﺶﻴﭘﺪﻧﻮﺷﻰﻣﺐﻴﻛﺮﺗﻢﻫﺎﺑﻰﺘﻗﻭ
ﺶﻫﻭﮋﭘﻦﻳﺍﺞﻳﺎﺘﻧﺮﮕﻳﺩﺯﺍ .ﺪﻨﻫﺩﻰﻣﻥﺎﺸﻧﺩﻮﺧﺯﺍIBSﻥﺎﻣﺭﺩ
ﻥﺍﻭﺭﺖﺤﺗIBSﻪﺑﻼﺘﺒﻣﺩﺍﺮﻓﺍﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳﻪﻛﺩﻮﺑﻦﻳﺍ
ﺯﺍﺮﺗﻻﺎﺑﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻰﺘﺧﺎﻨﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩ
ﺭﺍﺮﻗﻰﻳﺎﻬﻨﺗﻪﺑﻰﻳﻭﺭﺍﺩﻥﺎــﻣﺭﺩﺖﺤﺗﻪﻛIBSﻪﺑﻼﺘﺒﻣﺩﺍﺮــﻓﺍ
-ﻯﺭﺎﺘﻓﺭﻥﺎﻣﺭﺩﺯﺍﺲﭘﺶــﻳﺎﻣﺯﺁﻩﻭﺮﮔﻦﻴﻨﭽﻤﻫ .ﺩﻮﺑﺪــﻨﺘﻓﺮﮔ ﺢﻄﺳﺯﺍﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣﺭﺩﻝﺮﺘﻨﻛﻩﻭﺮﮔﻪﺑﺖﺒﺴﻧ،ﻰﺘﺧﺎﻨﺷ ﻩﻭﺮﮔﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳﺭﺩ .ﺪﻧﺩﻮﺑﺭﺍﺩﺭﻮﺧﺮﺑﻯﺮﺗﻻﺎﺑﺖﻣﻼﺳ ﺎﻣﺍ،ﺪــﺸﻧﺩﺎﺠﻳﺍﻯﺮﻴﻴﻐﺗ،ﺪﻧﺩﺮﻛﺖﻓﺎﻳﺭﺩﻭﺭﺍﺩﻂﻘﻓﻪــﻛﻝﺮﺘﻨﻛ ﻯﺮﺗﻻﺎﺑﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄــﺳﺯﺍﻥﺎﻣﺭﺩﺯﺍﺲﭘﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔ ﺖﺤﺗﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔ .ﺪــﻧﺩﻮﺑﺭﺍﺩﺭﻮﺧﺮﺑﻝﺮﺘﻨﻛﻩﻭﺮﮔﻪﺑﺖﺒــﺴﻧ
ﺶﻴﭘﻪﻠﺣﺮﻣﻪﺑﺖﺒــﺴﻧﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣﺭﺩﺰﻴﻧCBTﻥﺎﻣﺭﺩ
ﻦﻳﺍ .ﺪﻧﺪﻳﺩﺮﮔﺭﺍﺩﺭﻮﺧﺮﺑﻯﺮﺗﻻﺎﺑﻰﻧﺍﻭﺭﺖﻣﻼﺳﺢﻄﺳﺯﺍ،ﻥﻮﻣﺯﺁ
ﺲﻳﻮﺑ .ﺪﺷﺎﺑﻰﻣ [5ﻭ 6] ﺕﺎﻌﻟﺎﻄﻣﻰﺧﺮﺑﺞﻳﺎﺘﻧﺎﺑﻮــﺴﻤﻫﺞﻳﺎﺘﻧ
-ﻰﻧﺍﻭﺭ -ﻰﺘــﺴﻳﺯﻯﻮﮕﻟﺍﻪﺑﻪﺟﻮﺗﺎﺑ :ﺪﻧﺩﻮﻤﻧﺡﺮﻄﻣﻥﺍﺭﺎﻜﻤﻫﻭ ﻥﺍﻭﺭﻯﺎﻬــﺷﻭﺭ،ﻒﻃﺍﻮﻋﻭﻩﺩﻭﺭﺩﺮﻜﻠﻤﻋﻞﺧﺍﺪﺗﺭﺩﻰــﻋﺎﻤﺘﺟﺍ ﺯﺎﺑﻪﻘﻠﺣﻪﻛﺪﻨﻧﺁﺮﺑﺎﻬﻧﺎﻣﺭﺩﻦﻳﺍﻭﺪﻧﺍﻩﺪﺷﻯﺰﻳﺭﻰﭘﻯﺮﮕﻧﺎﻣﺭﺩ ﺶﻫﺎﻛﺭﻮﻈﻨﻣﻪﺑﺍﺭﻩﺩﻭﺭﺩﺮﻜﻠﻤﻋﻭﻒــﻃﺍﻮﻋﻦﻴﺑﻰﻔﻨﻣﺩﺭﻮﺧ .ﺪﻨﻨﻜﺷﻢﻫﺭﺩﻯﺭﺎﻤﻴﺑﻯﺎﻫﻪﻧﺎﺸﻧ
ﻱﺮﻴﮔ
ﻪﺠﻴﺘﻧ
ﻪﺑﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮــﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﺖــﻔﮔﻥﺍﻮﺘﺑﺪﻳﺎــﺷﺢﻄــﺳﻭﺶﻫﺎﻛﺍﺭIBSﻯﺎﻫﻪﻧﺎــﺸﻧﻯﺮــﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮــﻤﻫ
ﻉﺎﺟﺭﺍﻡﻭﺰﻟﻦﻳﺍﺮﺑﺎﻨﺑ .ﺪﻫﺩﻰﻣءﺎﻘﺗﺭﺍﺍﺭﻥﺍﺭﺎﻤﻴﺑﻰﻧﺍﻭﺭﺖﻣﻼــﺳ
ﻚــﺷﺰﭘﻂــﺳﻮﺗ،ﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﺖﻓﺎﻳﺭﺩﺎﺑﻩﺍﺮﻤﻫﻥﺍﺭﺎﻤﻴﺑﻦﻳﺍ
ﺖﻬﺟ،ﻥﺎــﺳﺎﻨﺸﻧﺍﻭﺭﻭﻥﺎﻜــﺷﺰﭘﻥﺍﻭﺭﻪﺑﺵﺭﺍﻮﮔﺺــﺼﺨﺘﻣ
ﺯﺍ .ﺪﻨﻛﻰﻣﺍﺪﻴﭘﻰﻬﺟﻮﺗﻞﺑﺎﻗﺕﺭﻭﺮﺿ،ﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﻝﺎــﻤﻋﺍ
ﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭﻒﻗﻮﺗﺮﺛﺍﺭﺩﻯﺭﺎﻤﻴﺑﺩﻮﻋﺖﺳﺍﻦﻜﻤﻣﻪﻛﺎﺠﻧﺁ
ﻥﻮﻣﺯﺁﺲﭘﻪﻠﺣﺮﻣﺭﺩﻝﺮﺘﻨﻛﻭﺶﻳﺎﻣﺯﺁﻩﻭﺮﮔﻭﺩﻦﻴﺑSCL-90-Rﻥﻮﻣﺯﺁﻱﺎﻬﺳﺎﻴﻘﻣﻩﺩﺮﺧﻱﺭﺎﻣﺁﻱﺎﻫﺺﺧﺎﺷﻪﺴﻳﺎﻘﻣ - 3 ﻝﻭﺪﺟ
SCL-90-Rﻱﺎﻬﺳﺎﻴﻘﻣ ﻩﻭﺮﮔ ﻦﻴﮕﻧﺎﻴﻣ ﺭﺎﻴﻌﻣﻑﺍﺮﺤﻧﺍ tﺭﺍﺪﻘﻣ ﻯﺩﺍﺯﺁﻪﺟﺭﺩ ﻯﺭﺍﺩﺎﻨﻌﻣﺢﻄﺳ ﻲﻧﺎﻤﺴﺟﺖﻳﺎﻜﺷ ﺶﻳﺎﻣﺯﺁ 0,84 0,63 4,90 48 0,0001 ﻝﺮﺘﻨﻛ 1090 0,81 ﺭﺎﺒﺟﺍﻭﺱﺍﻮﺳﻭ ﺶﻳﺎﻣﺯﺁ 1,06 0,49 4,34 48 0,0001 ﻝﺮﺘﻨﻛ 1,96 0,83 ﻞﺑﺎﻘﺘﻣﻂﺑﺍﻭﺭﺭﺩﺖﻴﺳﺎﺴﺣ ﺶﻳﺎﻣﺯﺁ 0,86 0,52 4,04 48 0,0001 ﻝﺮﺘﻨﻛ 1,68 0,80 ﻲﮔﺩﺮﺴﻓﺍ ﺶﻳﺎﻣﺯﺁ 1,01 0,53 3,23 48 0,002 ﻝﺮﺘﻨﻛ 1,80 0,99 ﺏﺍﺮﻄﺿﺍ ﺶﻳﺎﻣﺯﺁ 0,64 0,45 4,57 48 0,0001 ﻝﺮﺘﻨﻛ 1,69 0,94 ﻱﺮﮕﺷﺎﺧﺮﭘ ﺶﻳﺎﻣﺯﺁ 0,80 0,64 3,93 48 0,0001 ﻝﺮﺘﻨﻛ 1,88 1,10 ﻲﺿﺮﻣﺱﺮﺗ ﺶﻳﺎﻣﺯﺁ 0,40 0,41 3,94 48 0,0001 ﻝﺮﺘﻨﻛ 1,25 0,89 ﻱﺪﻴﺋﻮﻧﺍﺭﺎﭘﺭﺎﻜﻓﺍ ﺶﻳﺎﻣﺯﺁ 1,00 0,69 3,10 48 0,003 ﻝﺮﺘﻨﻛ 1,79 0,97 ﻰﮕﺘﺴﺴﮔﻥﺍﻭﺭ ﺶﻳﺎﻣﺯﺁ 0,82 0,40 3,56 48 0,001 ﻝﺮﺘﻨﻛ 1,41 0,66
ﺖﺤﺗﻯﺮﺗﻰﻧﻻﻮﻃﺕﺪﻤﺑﻥﺍﺭﺎﻤﻴﺑﺖــﺳﺍﺮﺘﻬﺑﺩﻮﺷﻩﺪﻫﺎــﺸﻣ
ﻯﺮﮕﻧﺎﻣﺭﺩﻭﺭﺍﺩﻩﺍﺮﻤﻫﻪﺑﻰﺘﺧﺎﻨــﺷ -ﻯﺭﺎﺘﻓﺭﻯﺮﮕﻧﺎﻣﺭﺩﻥﺍﻭﺭ
.ﺩﺮﻴﮔﺭﺍﺮﻗ
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ﻊﺑﺎﻨﻣ
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