功能性消化不良的心理社会因素研究

A study of psychosocial factors in functional dyspepsia.

目的探讨功能性消化不良(functional dyspepsia,FD)患者有关的心理社会因素。方法对50例FD患者和30例正常人进行明尼苏达多相人格调查表(MMPI)、汉米尔顿抑郁量表(HAMD)、汉米尔顿焦虑量表(HAMA)、生活事件量表(LES)、社会支持量表(SS)、多伦多述情障碍量表(TAS)评定。将患者随机分为常规治疗组和合用帕罗西汀组,治疗2个月后(两组失访2例和4例)观察患者上述量表评分的变化及其与消化不良症状变化的关系。结果治疗前,与正常对照组比较,患者组TAS、HAMD、HAMA总分高,MMPI提示人格有偏移。治疗后,合用帕罗西汀组的HAMD分、HAMA分及症状的改善均优于常规组。结论FD患者的人格因素和述情方式有明显异常,存在抑郁焦虑等负性情绪。常规治疗加帕罗西汀可改善患者的抑郁焦虑症状,从而有助于消化不良症状的缓解。

Objective The preliminary study was to explore the psychosocial factors in functional dyspepsia.Methods 50 patients with FD were assessed by scale for minnesota multiphasic personality inventory（MMPI）,hamilton depression scale（HAMD）,hamilton anxiety scale（HAMA）,life event scale（LES）,toronto alexithymia Scale（TAS）,social support scale（SS）.The control group consisted of 30 normal chinese individuals.The patients were randomly divided into two groups,one being treated with famotidine 20 mg and domperidone 10 mg,two times and three times per day respectively,the other treated with famotidine and domperidone in combination with paroxetine 20 mg daily for 8 weeks.Results Patients with functional dyspepsia had significantly higher scores in scale Hs,D,Hy,Pd,Pt,Sc of MMPI,and in the three mood scales（HAMD,HAMA,TAS）compared with the controls.After treatment,the improvements on HAMA nad HAMD and dyspeptic symptoms were better in patients receiving combination therapy than in patients with the routine therapy.Conclusion Patiens with functional dyspepsia had personality and mood disturbance.The medication of paroxetine combined with the routine therapy for functional dyspepsia may probably be helpful in improving the patients＇mood.