胃食管反流病患者精神心理状态及其对质子泵抑制剂治疗的影响

Psychological status of patients with gastroesophageal reflux disease and its effect on the treatment of proton pump inhibitor

目的探讨胃食管反流病(GERD)患者精神心理状态对质子泵抑制剂治疗效果的影响。方法选择2017年3月至2018年3月东莞市桥头医院收治的80例GERD患者作为研究对象(GERD组),其中非糜烂性反流病(NERD)患者56例,反流性食管炎(RE)患者24例,选取同期本院体检中心健康志愿者80例为对照组。采用反流性疾病问卷(RDQ)、匹兹堡睡眠质量指数量表(PSQI)和综合医院焦虑抑郁量表(HADS)评价三组研究对象的精神心理状态,并对影响质子泵抑制剂(PPI)疗效的可能危险因素进行多因素Logistic回归分析。结果 GERD组患者的焦虑、抑郁状态及睡眠障碍发生率分别为47.5%、40.0%及57.5%,均明显高于对照组的7.5%、5.0%及10.0%,差异均有统计学意义(P<0.05);RE患者焦虑、抑郁状态及睡眠障碍发生率分别为41.7%、37.5%及66.7%,与NERD患者的50.0%、41.1%及53.6%比较,差异均无统计学意义(P>0.05);多因素Logistic回归分析结果显示,NERD、焦虑、抑郁和睡眠障碍是影响PPI疗效的独立影响因素(P<0.05)。结论 GERD患者存在不同程度的焦虑、抑郁及睡眠障碍,治疗时考虑精神心理因素的影响可提高GERD患者PPI的治疗效果。

Objective To explore the effect of psychological status of patients with gastroesophageal reflux disease(GERD) on the treatment of proton pump inhibitor. Methods A total of 80 patients with GERD admitted in Dongguan Qiaotou Hospital from March 2017 to March 2018 were selected as research objects, including 24 cases of reflux esophagitis(RE) and 56 cases of non-erosive reflux disease(NERD). During the same period, 80 healthy volunteers in the hospital were selected as the control group. Reflux disease questionnaire(RDQ), Pittsburgh sleep quality index(PSQI), and Hospital Anxiety and Depression Scale(HADS) were used to evaluate the mental state of the three groups,and multiple Logistic regression analysis was performed to analyze the possible risk factors influencing the efficacy of proton pump inhibitor(PPI). Results The incidence of anxiety and depression in GERD patients was 47.5%, 40.0%,and 57.5%, significantly higher than 7.5%, 5.0%, and 10.0% in the control group(P<0.05). There were no statistically significant difference between RE(41.7%, 37.5% and 66.7%) and NERD(50.0%, 41.1% and 53.6%) with anxiety depression and sleep disorders(P>0.05). Multiple logistic regression analysis showed NERD, anxiety, depression and sleep disorders were independent predictors of therapeutic effect of PPI(P<0.05). Conclusion Varying degrees of depression, anxiety and sleep disorders can exist in GERD patients, and considering the role of psychological factors in the treatment of GERD patients with PPI drug can improve the clinical efficacy.