胃食管反流病合并焦虑及抑郁状态初步临床评估

Initial clinical evaluation of the states of anxiety and depression in gastroesophageal reflux disease patients

目的比较胃食管反流病(gastroesophageal reflux disease,GERD)中非糜烂性反流病(non-erosive reflux disease,NERD)与反流性食管炎(reflux esophagitis,RE)患者精神心理异常症状表现,为其有效治疗提供依据。方法选择反酸、烧心、胸骨后疼痛为主诉,伴焦虑和(或)抑郁症状的患者,经胃食管反流病问卷(Gred Q)调查确定为GERD者为研究对象,依据胃镜检查结果分为RE组和NERD组。两组均进行汉密尔顿焦虑、抑郁量表问卷调查。结果 GERD伴焦虑和(或)抑郁患者共52例,其中NERD患者32例、RE患者20例。年龄、病程、文化程度及Gred Q评分等两组比较,差异无统计学意义(P<0.05);抑郁状态患者中NERD组27例(84.4%),RE组19例(95.0%),抑郁量表评分两组比较,差异无统计学意义(P>0.05);焦虑状态患者中NERD组32例(100%),以女性为主(84.4%),RE组20例(100%),女性7例(35.0%),焦虑量表评分两组比较,差异有统计学意义(P<0.05);焦虑合并抑郁状态患者中NERD组27例(84.4%),RE组19例(95.0%),两组比较,差异无统计学意义(P>0.05)。结论 GERD合并精神心理异常症状的患者中,NERD患者呈焦虑状态比例较RE高,且女性患病率高。汉密尔顿焦虑、抑郁量表测评有助于GERD伴有精神心理异常症状患者心理干预和(或)药物治疗的选择。

Objective To compare abnormal psychological symptoms among non-erosive reflux disease（NERD） and reflux esophagitis（ RE） patients in gastroesophageal reflux disease（ GERD）,and to provide the evidence for the effective treatment. Methods Acid reflux,heartburn,retrosternal pain as chief complaint,while patients with anxiety and（or） depression symptoms,the gastroesophageal reflux disease questionnaire（Gred Q） survey identified GERD were chosen as the research object. Gastroscopy indicated that the patients whose lower esophageal mucosa being damaged were enrolled as RE. The rest were enrolled the NERD. Both of two groups were adopted depression scale questionnaire and Hamilton anxiety. Results Depression and / or anxiety were found in total of 52 GERD patients,including 32 NERD patients and 20 RE patients. There were no significant differences in age,course of disease,culture degree and the Gred Q score,etc between two groups（ P〈0. 05）. There were 27 NERD patients with depression（84. 4%） and the same condition in RE were 19 patients（95. 0%）. Symptom scores had no significant difference between the two groups（ P〈0. 05）. There were 32 cases in NERD patients with anxiety（100%）,female cases were 27,which occupied for 84. 4% of total. There were 20 RE patients with anxiety（100%）,female were 7 patients（35. 0%）. Symptom scores was significantly different between two groups（ P〈0. 05）; the NERD patients with depression and anxiety was in27 patients（84. 4%） and the same conditions was seen in RE patients（95. 0%）,and there was no significant difference between two groups（ P〈0. 05）. Conclusion In the patients who suffer from GRED and psychological anomaly,NERD patients show more anxiety than RE patients,and the female patients have high prevalence rate. The methods of Hamilton anxiety and depression scale assessment are helpful to GERD patients with mental abnormality providing information for medication.