胃食管反流病的危险因素及相关心理因素分析并疗效观察

Analyzing the risk factors and related psychological factors in patients with gastroesophageal reflux disease and surveying the curative effect

目的分析胃食管反流病（GERD）的危险因素及相关心理因素并观察疗效。方法随机选取2006年1月至2008年1月符合GERD诊断患者200例（GERD组）及健康对照者200例（对照组），调查两组的个人资料，分别采用RDQ量表及Zung抑郁自评量表（SDS）测评。比较两组的各种危险因素及GERD组患者治疗前后RDQ量表和SDS评分变化。结果GERD组高学历、城区居住、婚姻不稳定、有工作压力、高体重指数、有吸烟史、有饮酒史、有胃病家族史、使用非甾体抗炎药（NSAID）的比例均高于对照组（P均〈0．01）。GERD组治疗前RDQ量表评分〉12分有196例患者，治疗后有8例患者，治疗前后比较差异有统计学意义（P〈0．01）。GERD组治疗前SDS评分〉40分有18例患者，治疗后有3例患者，治疗前后比较差异有统计学意义（P〈0．01）。结论GERD患者存在较多危险因素，特别是心理因素，治疗消化系统疾病的同时需要进行综合心态调整治疗，避免过度肥胖、吸烟、饮酒、过量使用NSAID等。

Objective To analyze the risk factors and related psychological factors in patients with gastroesophageal reflux disease （GERD）and survey the curative effect. Methods All of 200 outpatients with GERD（ GERD group ） and 200 healthy persons （control group）from January 2006 to January 2008 were randomly selected, and the personal data were investigated. The GERD questionnaire （RDQ） and the Zung-self-rating depression scale （SDS） test were used. Results In GERD group, the proportions of high education, city living, marriage instability ,heavy working pressure, high body mass index （BMI）,smoking and drinking habit, peptic disease in family, using nonsteroidal anti-inflammatory drugs （NSAIDs） were higher than those in control group （P all 〈 0.01 ）. After treatment, the patients in GERD group had lower scores in the RDQ and SDS test than those before treatment （P 〈 0.01 ）. Conclusions There are many risk factors in patients with GERD, especially the psychological factors. The therapy of GERD should combine with psychotherapy and avoid high BMI, smoking, drinking and overusing the NSAID.