胃肠功能性疾病患者应激反应水平和心理健康状况研究

Study on the level of stress response and mental health of patients with gastrointestinal functional diseases

目的探索胃肠功能性疾病患者的应激反应水平和心理健康状况。方法回顾性研究2016年5—10月本院收治的胃肠功能性疾病患者74例作为研究组,选取同期住院治疗的非胃肠功能性疾病患者73例作为对照组,分析两组患者应激反应水平和心理健康状况差异。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗前,研究组餐后胀满、早饱感、食欲不振、恶心或呕吐发生率分别为32.43%、28.38%、44.59%、29.73%,均显著高于对照组的16.44%、5.48%、20.55%、15.07%,差异均有统计学意义(均P<0.05)。治疗前、治疗后3天,研究组的焦虑和抑郁水平分别为(36.47±5.34)、(35.32±6.17)、(28.36±5.04)、(28.29±5.58)分,均显著高于对照组的(33.26±5.47)、(32.28±6.36)、(23.51±4.26)、(24.85±5.24)分,差异均有统计学意义(均P<0.05)。研究组和对照组治疗后的焦虑和抑郁水平均显著低于治疗前,差异均有统计学意义(均P<0.05)。治疗前及治疗后1、3、5天研究组患者的血浆内皮素(endothelin,ET)和血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)水平分别为(57.82±9.53)、(53.36±9.16)、(49.65±8.32)、(47.45±7.73)ng/L,均显著高于对照组的(49.47±7.45)、(47.34±7.27)、(45.43±6.57)、(42.61±6.07)ng/L,差异均有统计学意义(均P<0.05)。研究组患者躯体化、强迫症状、抑郁、焦虑、偏执和精神病性得分分别为(1.84±0.44)、(1.82±0.36)、(1.72±0.42)、(1.67±0.36)、(1.56±0.27)、(1.61±0.29)分,显著高于对照组的(1.57±0.36)、(1.69±0.34)、(1.56±0.34)、(1.52±0.32)、(1.38±0.26)、(1.35±0.27)分,差异均有统计学意义(均P<0.05)。结论胃肠功能性疾病患者的胃肠道不适感更多且强烈,焦虑和抑郁状况明显,应激反应水平较高,心理健康状况较差。

Objective To explore the level of stress response and mental health in patients with gastrointestinal functional diseases. Methods A retrospective study from May to October 2016,74 cases of hospitalized patients and 73 hospitalized patients with non functional gastrointestinal disease were selected. The differences between the two groups in response to stress level and psychological health were analyzed. Measurement data between groups was processed by t test, in groups were processed by paired t test, count data was processed by chi-square test, P〈0.05 was considered statistically significant. Results Before treatment, the incidence rate of postprandial fullness, early satiety, in appetence and nausea or vomiting in the research group were 32.43%,28.38%,44.59%,29.73%, which were significantly higher than the control group（16.44%,5.48%,20.55%,15.07%）, the differences were statistically significant（all P〈0.05）. The anxiety and depression levels of the study group before treatment and 3 days after treatment were（36.47±5.34）,（35.32±6.17）,（28.36±5.04）,（28.29±5.58） points, higher than that of the control group[（33.26±5.47）,（32.28±6.36）,（23.51±4.26）,（24.85±5.24） points], the differences were statistically significant（all P〈0.05）. After treatment, the level of anxiety and depression were significantly lower than those before treatment, the differences were statistically significant（all P〈0.05）. The level of plasma endothelin（ET） and angiotensin II（Ang II） before treatment and one day, three days and five days after treatment of research group were（57.82±9.53）,（53.36±9.16）,（49.65±8.32）,（47.45±7.73）ng/L,higher than that of the control group [（49.47±7.45）,（47.34±7.27）,（45.43±6.57）,（42.61±6.07）ng/L）], the differences were statistically significant（all P〈0.05）. The scores of somatization, obsessive-compulsive symptoms, depression, anxiety, paranoia and psychosis in the study group were（1.84±0.44）,（1.82±0.36）,（1.72±0.42）,（1.67±0.36）,（1.56±0.27）,（1.61±0.29） points, higher than those of the control group [（1.57±0.36）,（1.69±0.34）,（1.56±0.34）,（1.52±0.32）,（1.38±0.26）,（1.35±0.27） points], the differences were statistically significant（all P〈0.05）. Conclusion Gastrointestinal dysfunction patients with gastrointestinal discomfort more and more intense, anxiety and inhibition status is obvious, high level of stress response, poor mental health.