功能性胃肠疾病与抑郁症的关系及治疗

The relationship and treatment between functional gastrointestinal disorders and depression

目的探讨功能性胃肠疾病(FGID)患者的心理健康状况、个性特征及有效的治疗措施。方法回顾性分析我院2008年2月～2011年2月收治的功能性消化不良(FD)和肠易激综合征(IBS)的患者共100例(观察组),另选择我院同期健康体检者100例作为健康对照组,两组给予症状自评表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)进行测试并比较。结果功能性胃肠病患者中有57例(57%)出现抑郁症状,健康对照组有17例(17%),两组发生率比较差异有高度统计学意义(P<0.01);伴有抑郁的观察组患者血清褪黑素(MT)和血浆胃动素水平明显低于不伴有抑郁的FGID患者和健康对照组,差异均有高度统计学意义(均P<0.01);不伴有抑郁观察组与健康对照组血清MT和血浆胃动素水平无明显差异(P>0.05);两组生理健康子量表总分、心理症状与负向情绪、正向情绪、认知功能、心理健康子量表总分、社会资源与社会接触、社会健康子量表总分、自测健康评定量表测试版总分等比较差异有统计学意义(P<0.05)。观察组患者应用抗消化不良药物、抗忧郁焦虑药物、联合抗抑郁焦虑治疗,治疗3个月后各量表均减分明显,有效率达86.67%。结论 FGID与精神心理因素有一定关系,FGID患者的治疗除常规用药外,还应进行针对性心理治疗。

Objective To study the mental health status,the personality characteristics,and the effective treatment measures of the functional gastrointestinal diseases（FGID） patients.Methods 100 patients（the observation group）with functional indigestion（FD） and irritable bowel syndrome（IBS） in our hospital from February 2008 to February 2011 were analyzed retrospectively,and 100 cases of healthy people were selected as control group.Two groups were all given symptoms from review table（SCL-90）,depression self rating scale（SDS）,anxiety from rating scale（SAS） test and the test results were compared.Results 57 cases（57%） in functional gastrointestinal group and 17 cases（17%） in healthy control group showed depressive symptoms.The differences between the two groups were all significantly significant（P 0.01）.Serum MT and plasma stomach move element level of FGID patients with depression were obviously lower than FGID patients with no depression and people in control group,the differences were significant significant（P 0.01）,serum MT and plasma stomach move element level of FGID patients with no depression and people in control group were not significantly different（P 0.05）;the difference of Physiological health son scale total score,Psychological symptoms and negative emotions,Positive Emotion,cognitive function,Mental health scale son total scoreSocial resources and social contact,Social health son scale total score,self test healthy rating scale score between two groups were not significantly different（P 0.05）;patients with FGID were given indigestion drugs,antidepressants,anxiety drugs joint antidepressant anxiety treatment after 3 months treatment,the average scale of each form reduced obviously,the effective rate was 86.67%.Conclusion FGID is dependent with the spiritual psychological factors,the treatment of patients with FGID not only conventional medicine,but also should be targeted psychological treatment.