伴不同程度焦虑症状的咽异感症患者临床特征分析

Analysis on clinical characters of pharyngeal paraesthesia in patients with different degrees of anxiety

目的:分析伴不同程度焦虑症状的咽异感症患者的临床资料,了解疾病的基本临床特征及疗效,并初步分析焦虑状态的可能原因。方法:采用焦虑自评量表(SAS)将患者分为轻度、中度和重度焦虑3组,对比分析各组的一般情况、发病相关因素和疗效预后。采用状态-特质焦虑问卷(STAI)对患者进行焦虑状态分析,并和健康对照组比较。以SPSS13.0软件对数据进行统计学分析。结果:①女性(54.05%)伴焦虑症状的比例高于男性(45.95%),且女性伴发中度焦虑的比例高,而男性伴发轻度焦虑的比例高。伴发重度焦虑的比例男女之间差异无统计学意义(P>0.05)。②40~59岁年龄段伴发焦虑的比例最高(60.14%),且伴中度和重度焦虑的比例高于18~39岁和≥60岁年龄段(P<0.05);后2个年龄段之间比较,不同程度焦虑的患者比例差异无统计学意义(P>0.05)。③伴轻度和中度焦虑的患者比例分别在病程5~10年和5年以下最高;3个病程段均有一定比例的患者伴发重度焦虑,但差异无统计学意义(P>0.05)。④无固定职业和高中以下学历的患者伴发中度焦虑的比例高于有固定职业和高中及以上学历的患者(P<0.05),而伴发轻度和重度焦虑的患者比例与职业和受教育程度无关(P>0.05);焦虑程度与婚姻状况无关,无城乡差别(P>0.05)。⑤不同程度焦虑的患者中有恐癌症的比例均最高,其次为紧张压力大和精神刺激因素。有恐癌症和自觉紧张压力大的患者比例在重度焦虑组均高于中度和轻度焦虑组(P<0.01);精神刺激因素在各组间两两比较,差异无统计学意义(P>0.05);异物强迫思维症和精神病家族史在各组中的比例均较低,组间差异无统计学意义(P>0.05)。⑥伴不同程度焦虑的男性和女性患者分别与健康对照组男性和女性比较,状态焦虑(S-AI)得分均差异有统计学意义(P<0.05),而特质焦虑(T-AI)得分均差异无统计学意义(P>0.05)。⑦轻、中度焦虑组治愈率(P<0.05)和总有效率(P<0.01)均高于重度焦虑组,轻度焦虑和中度焦虑组治愈率和总有效率分别比较,差异无统计学意义(P>0.05)。结论:伴不同程度焦虑症状的咽异感症患者具有各自不同的临床特征和预后,疾病长期得不到改善是导致精神焦虑的主要原因,患者呈现状态焦虑,与常人相比无明显焦虑潜质。

Objective：To investigate the therapeutic effect and potential reason for anxiety in pharyngeal par- aesthesia in patients with different degrees of anxiety based on their characteristics. Method：All patients were di- vided into three groups according to self-rating anxiety scale（SAS）, including group 1 （mild anxiety）, group 2 （mod- erate anxiety）and group 3 （severe anxiety）. The characteristics, risk factors and prognosis in each group were com- pared and analyzed. Meanwhile, State-Trait Anxiety Inventory（STAI）was used to analyze anxiety state of all pa- tients and healthy participates（Group 4）. SPSS13.0 statistical software was used for data analysis. Result：The pro- portions of female patients （54. 05%） who had anxiety symptom were higher than those of male patients （45.95 % ）. The proportions of moderate anxiety in female patients were higher（P〈0.01）, but those of mild anxi- ety were lower（P〈0.01） compared with male patients. There was no gender difference about the proportions of severe anxiety. The patients aged 40--59 years had the highest proportions of anxiety （60. 14% ）and a higher pro- portions of moderate and severe anxiety compared with the patients aged 18-39 years and over 60 years old（P〈 0.05）. However, there wag no significant difference in proportions of different degrees of anxiety between the pa- tients aged 18-39 years and over 60 years old（P〈0.05）. The proportions of mild anxiety in patients with 5--10 years duration and those of moderate anxiety in patients with the course of less than 5 years were all the highest.However, no difference was found in proportions of severe anxiety among different courses（P〉0.05）. The pro- portions of moderate anxiety（except mild and severe anxiety） in patients with no fixed occupation and no senior middle school education were higher than those in patients with fixed occupation and senior middle school education or above（P-〈0.05）. But there were no relationships between the degrees of anxiety and other general conditions of patients, including marital status and live condition. Among different degrees of anxiety, the proportions of patients who feared cancer were all the highest, followed by stress and mental stimulation factors. The proportions of pa- tients who feared cancer and felt stress were higher in severe anxiety than those in mild and moderate anxiety. But there was no significant difference between any two groups in other related factors, including mental stimulation factors, obsessive-compulsive disorder（OCD） and family history of psychosis. Male and female patients with dif- ferent degrees of anxiety compared with healthy controls respectively,had significant difference in state anxiety（S- AI） scores（P〈0.05） ,but showed no significant difference in trait anxiety（T-AI） scores（P〉0.05）. Both recover- y rates and total effective rates of mild and moderate anxiety were higher than those of severe anxiety（P〈0.01）. However, there was no difference between mild and moderate anxiety whether in recovery rates or in total effective rates （P〉0.05）. Conclusion： Pharyngeal paraesthesia in patients with different degrees of anxiety has different clinical features and prognosis . The main cause of anxiety appears to be a long duration of treatment. No obvious anxiety potential was found in patients compared with normal people.