胃食管反流病患者精神心理状态与临床疗效的相关性研究

Correlation between psychological status and clinical efficacy in patients with gastroesophageal reflux disease

目的探讨胃食管反流病(gastroesophageal reflux disease,GERD)患者精神心理状态与临床疗效的相关性。方法选择2013年1月至2015年10月本院收治的GERD患者182例为研究对象,根据胃镜检查结果将其分为非糜烂性反流病(non-erosive reflux disease,NERD)组和反流性食管炎(reflux esophagitis,RE)组,选取同期本院体检中心健康志愿者80例纳入对照组。采用调查问卷方式分析三组研究对象焦虑自评量表(SAS)、抑郁自评量表(SDS)及匹兹堡睡眠质量指数量表(PSQI)评分及其与反流性疾病问卷(RDQ)评分的关系,并对影响质子泵抑制剂(proton pump inhibitor,PPI)疗效的可能危险因素进行多因素Logistic回归分析。结果 RE组与NERD组患者SAS、SDS及PSQI评分比较差异均无显著性(P>0.05),且两组患者SAS、SDS及PSQI评分均显著高于对照组(P<0.01)。GERD患者SAS、SDS及PSQI评分与RDQ评分均呈正相关(P<0.05);多元Logistic回归分析显示,NERD与SAS、SDS、PSQI评分是影响GERD患者PPI疗效的独立预测因素(P<0.05)。结论GERD患者存在不同程度的焦虑、抑郁及睡眠障碍,与其疾病的严重程度相关,因此治疗时考虑精神心理因素的影响,可提高GRED患者PPI治疗效果。

Objective To investigate the correlation between psychological status and clinical efficacy in patients with gastroesophageal reflux disease（GERD）. Method 182 patients with GERD admitted in our hospital from January 2013 to October 2015 were selected as the research objects, and they were divided into reflux esophagitis（RE） group and non-erosive reflux disease（NERD） group according to the gastroscope check results. Selected 80 cases of healthy volunteers as control group during the same period in our hospital. SAS, SDS and PSQI scores and their relationship with RDQ score were analyzed and performed multiple Logistic regression analysis on the possible risk factors might influence the efficacy of proton pump inhibitor（PPI） drugs. Result There were no significant differences between RE group and NERD group on SAS, SDS and PSQI scores（P〈0.05）, while their SAS, SDS and PSQI scores were significantly higher than control group（P〈0.05）; SAS, SDS and PSQI scores were positively related to RDQ score（P〈0.05）; multiple Logistic regression analysis showed, NERD, SAS, SDS, PSQI were independent predictors of therapeutic effect of PPI（P〈0.05）. Conclusion Varying degrees of depression, anxiety and sleep disorder can exist in GERD patients and are related to the severity of disease, so considering the role of psychological factors in the treatment of GERD patients with PPI drug can improve the clinical efficacy.