抗抑郁治疗对弥漫性食管痉挛患者心理及食管压力的影响

The Effect of Antidepressant Treatment on Psychological Status and Esophageal Pressure in Patients with DES

目的探讨抗抑郁治疗对弥漫性食管痉挛患者心理及食管压力的影响。方法将88例弥漫性食管痉挛(DES)患者设为干扰组,44例健康体检者设为对照组。干扰组又分为干预1组与干预2组,每组44例。干预1组患者入院后常规治疗,干预2组在干预1组治疗基础上给予抗抑郁治疗,对各组患者进行汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)评分及食管压力测定,对干预组进行消化道症状的综合评分。结果干预1组及干预2组患者治疗前的HAMD、HAMA评分及食管压力均高于健康对照组(P<0.05),干预1、2组治疗后的HAMD、HAMA评分及食管压力均低于治疗前(P<0.05);干预1、2组治疗后的食管蠕动波幅、食管收缩持续时间、食管运动异常率均低于治疗前(P<0.05);干预1组的总有效率为47.73%,干预2组的总有效率为81.82%,两组比较P<0.01,干预2组的总有效率明显高于干预1组。结论心理异常及食管运动功能紊乱对DES的发病存在一定的影响,抗抑郁治疗能迅速改善患者的消化道症状。

Objective To discuss the effect of antidepressant treatment on psychological status and esophageal pressure in patients with diffuse esophageal spasm （DES）. Methods 88 cases with DES were selected in interfere group and 44 healthy normal were select- ed in control group; the interference group was subdivided into 2 groups： interference group I and interference group II; routine treat- ment was performed in both interference group I and interference group II while antidepressant treatment was added to cases in interfer- ence group II; Hamilton Depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA） and esophageal pressure measurement were ap- plied to all the cases involved, and the comprehensive scores of gastrointestinal symptoms was made in interference group. Results The scores of HAMD and HAMA and the esophageal pressure in interference group before treatment were higher than those in control group （P〈0.05）; the scores of HAMD and HAMA and the esophageal pressure in interference group after treatment were lower than those be- fore treatment （P〈0.05）; esophageal peristalsis amplitude, duration of esophageal shrinkage and abnormal esophageal movement rate of the cases in interference group after treatment were lower than those before treatment （P〈0.05）; the total effective rate in interference group II was 81.82% which was higher than that in interference group I （47.73%） （P〈0.01）. Conclusions Psychological abnormality and esophageal motility function disorder have a certain impact on DES occurrence and antidepressant treatment can improve the gastrointes- tinal symptoms rapidly.