精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用

Role of psychological factor in the overlapping symptoms of irritable bowel syndrome and functional dyspepsia

目的探讨精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用。方法对38例肠易激综合征(IBS)与功能性消化不良(FD)重叠症患者采用汉密尔顿焦虑量表(HAMA)14项和汉密尔顿抑郁量表(HAMD)17项版本进行心理测评,并将调查对象分为体力劳动组和非体力劳动组,比较分析各组评分的特点。结果女性FD与IBS重叠症患者焦虑抑郁障碍发病率较男性无显著性差异(68.2%vs 75.0%,χ2=0.21,P>0.05),非体力劳动者FD与IBS重叠症患者焦虑抑郁障碍发病率较体力劳动者显著升高(85.2%vs 36.4%,χ2=9.09,P<0.005)。结论非体力劳动者FD与IBS重叠症患者合并精神心理压力可能通过增加内脏敏感性使FD与IBS重叠症发病率更高,提示心理治疗可能有助于治疗FD与IBS重叠症。

Objective To detect the role of psychological factor in the overlapping symptoms of irritable bowel syn- drome （IBS） and functional dyspepsia （FD）by HAMA and HAMD. Methods Hamilton anxiety scale （HAMA）and Hamilton depression scale （HAMD） were measured in 38 patients with overlapping symptoms of IBS and FD. Results The prevalence of anxiety and depression symptom in patients with the overlapping symptoms of IBS and FD had no difference between female and male patients （68.2% vs 75.0% ,X2 = 0.21 ,P 〉 0.05 ） ; the prevalence of anxiety and depression symptom in non-physical laborers with the overlapping symptoms of IBS and FD was higher than physical laborers （85.2% vs 36.4% ,X2 = 9.09,P 〈 0. 005）. Conclusion Anxiety and depression symptom in non-physical laborers with the overlapping symptoms of IBS and FD maybe increase visceral sensation. These indicate that psychotherapy may be helpful in treatment of the overlapping symptoms of IBS and FD.