Objective: Although previous epidemiological studies have reported substantial links between inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), and celiac disease (CeD), the causal relationship between the two remains unknown. The purpose of the current study was to evaluate the bidirectional causation between IBD and CeD using Mendelian randomization (MR).Method: We obtained genome-wide association study (GWAS) summary data of IBD (CD and UC) and CeD of thoroughly European ancestry from the IEU GWAS database. We screened eligible instrumental variables (IVs) according to the three assumptions of MR. MR was performed using MR-Egger, weighted median (WM), and inverse variance weighted (IVW) methods. The MR-Egger intercept and MR-PRESSO method investigated the horizontal pleiotropy effect. A leave-one-out analysis was performed to prevent bias caused by a single SNP.Results: The study assessed a bidirectional causal effect between CD and CeD; CD increased the risk of CeD (IVW odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.19–1.35, p = 3.75E-13) and vice-a-versa (IVW OR = 1.09, 95% CI = 1.05–1.13, p = 1.39E-05). Additionally, CeD was influenced by IBD (IVW OR = 1.24, 95% CI = 1.16–1.34, p = 9.42E-10) and UC (IVW OR = 0.90, 95% CI = 0.83–0.98, p = 0.017). However, we observed no evidence of a causal relationship between CeD and IBD (IVW OR = 1.00, 95% CI = 0.97–1.04, p = 0.900) or UC (IVW OR = 0.96, 95% CI = 0.92–1.02, p = 0.172).Conclusion: The present study revealed that IBD and CeD have a bidirectional causal relationship. However, it is slightly different from the results of previous observational studies, recommending that future studies focus on the mechanisms of interaction between CD and CeD.
Background: Protracted withdrawal symptoms(PWS) play a crucial role in relapse. While medication maintenance or behavioral therapies such as cognitive behavioral therapy (CBT) can alleviate these symptoms, their implementation is still limited. Evidence suggests that Chinese tuina / massage therapy can improve mood and sleep quality in individuals experiencing PWS. However, high-quality, evidence-based studies supporting this claim are still lacking. Methods and analysis A prospective, parallel, three-armed, single-center, assessor-blinded, randomized controlled trial will be conducted with 69 patients at the Sichuan Ziyang Drug Rehabilitation Center (SZDRC). Patients undergoing PWS will be randomly assigned in a 1:1:1 ratio to three groups: CBT+tuina (Group A), CBT only (Group B), and waitlist (Group C). Group A will receive 2 sessions of CBT and 12 sessions of head and face massage for 4 weeks, while Group B will receive only 2 sessions of CBT over the same period. Group C will not receive any intervention during the treatment period and will receive the same compensatory treatment as Group A after the trial.The primary outcome will be measured using the Symptom Checklist 90 (SCL-90), and secondary outcomes will include the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI). Measurements will be obtained at baseline, 1 week after treatment completion, and at the end of follow-up. Data analysis will be conducted by independent statisticians using intention-to-treat analysis. Discussion: This study aims to investigate the efficacy and safety of CBT combined with head tuina/massage for protracted withdrawal symptoms. Questionnaires will be used to assess the degree of improvement in negative mood and sleep status. High-quality, evidence-based evidence will be obtained to reduce the pressure on the development of addiction treatment. Trial registration number: This study has been registered on Chinese Clinical Trials.gov with number ChiCTR2200058212 and has obtained ethics approvals from the Ethics Committee of the People's Hospital of Ziyang with number 2021-K-LS-2.
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