抗焦虑抑郁治疗对功能性消化不良患者症状及胃功能的影响

The effect of anti-anxiety-depression treatment on symptoms and gastric function in functional dyspepsia

目的评价抗焦虑抑郁治疗对功能性消化不良（FD）的作用。方法以焦虑自测量表（SAS）、抑郁自测量表（SDS）、水负荷试验分别评定20名FD患者和20名健康对照者的精神心理状态及胃感觉功能，并对存在焦虑抑郁FD患者抗焦虑抑郁治疗2周后的精神心理状态、胃感觉功能及消化不良症状进行再次评价。结果FD患者中焦虑抑郁的发生率（12／20）明显高于健康对照者（3/20）（P〈0．01）。焦虑抑郁FD患者的饮水最大耐受量为（758．3±202．1）ml，较无焦虑抑郁FD患者的（956．3±204．3）ml显著降低（P〈0．05）。抗焦虑抑郁治疗后FD患者的SAS、SDS及消化不良症状评分均明显降低（P〈0．01），饮水最大耐受量为（908．3±214．1）ml，较治疗前明显增加（P〈0．01）。结论精神心理障碍与FD的发生密切相关，抗焦虑抑郁治疗可能通过改善胃的敏感性来缓解消化不良症状。

Objective To explore the effect of anti-anxiety-depression treatment on functional dyspepsia （FD）. Methods Self- Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS）, water loading test were used to evaluate the psychological state and gastric sensory function in 20 FD patients and 20 healthy controls. The psychological state, gastric sensory function and dyspepsia symptoms in FD patients with anxiety or depression were reevaluated after two-week anti-anxiety-depression treatment, Results The incidence rate of anxiety and depression were higher in FD patients than in healthy controls, 12/20 versus 3/20 （P 〈 0.01）. Maximal water intake was significantly lower in FD patients with anxiety or depression （758.3 ± 2002.1）ml than in FD without anxiety or depression （956.3 ± 04.3）ml （P〈 0.05）. Compared with those before treatment, the scores of SAS, SDS and dyspepsia symptoms decreased significantly （P 〈 0.01） and maximal water intake （908.3 ± 214.1）ml increased significantly （P〈 0.01） in FD patients with anxiety or depression. Conclusions Psychological distress has close relationship with FD. Anti-anxiety-depression treatment may relieve dyspepsia symptoms by means of improving gastric sensitivity.