综合护理干预对反流性食管炎患者焦虑、抑郁、心理、睡眠、依从性、生活质量及相关血液指标的影响

Effects of comprehensive nursing intervention on anxiety,depression,psychology,sleep,compliance,life quality and related blood index of patients with reflux esophagitis

目的探讨综合护理干预对反流性食管炎患者的疗效、心理、睡眠、依从性、生活质量及血液中胃动素、胃泌素、血管活性肠肽、炎性因子的影响。方法反流性食管炎患者179例,男93例,女86例。随机分为两组,对照组81例,观察组98例,两组一般资料比较,P>0.05。对照组给予多潘立酮和泮托拉唑钠肠溶片治疗,观察组在对照组基础上加用消炎利胆片。两组均连续行8周治疗。对照组采用常规护理,观察组采用综合护理干预。两组治疗前、治疗后60天采用焦虑自评量表、抑郁自评量表、心理量表、睡眠质量指数量表、健康状况调查问卷评分及抽晨起静脉血检测胃泌素、胃动素、血管活性肠肽、白介素-6、白介素-8、肿瘤坏死因子-α、依从性、典型反流性食管炎症状评分。所获数据采用方差分析、t检验和2检验。结果对照组干预前后焦虑、抑郁、睡眠质量、生活质量评分比较,P均<0.0005。观察组干预前后焦虑、抑郁、睡眠质量、生活质量评分比较,P均<0.0005。两组干预后焦虑、抑郁、睡眠质量、生活质量评分比较,P均<0.0005。对照组干预前后社会功能、躯体疼痛、生理功能、活力、精神状态、情感活动评分比较,P均<0.0005。观察组干预前后社会功能、躯体疼痛、生理功能、活力、精神状态、情感活动评分比较,P均<0.0005。两组干预后社会功能、躯体疼痛、生理功能、活力、精神状态、情感活动评分比较,P均<0.0005。对照组干预前后胃动素、胃泌素、血管活性肠肽水平变化比较,P均<0.0005。观察组干预前后胃动素、胃泌素、血管活性肠肽水平变化比较,P均<0.0005。两组干预后胃动素、胃泌素、血管活性肠肽水平变化比较,P均<0.0005。对照组干预前后血清白介素-6、白介素-8、肿瘤坏死因子-α水平变化比较,P均<0.0005。观察组干预前后血清白介素-6、白介素-8、肿瘤坏死因子-α水平变化比较,P均<0.0005。两组干预后血清白介素-6、白介素-8、肿瘤坏死因子-α水平变化比较,P均<0.0005。对照组干预前后恶心呕吐、胃脘胀痛、胸骨后疼痛、烧心、反酸嗳气评分比较,P均<0.0005。观察组干预前后恶心呕吐、胃脘胀痛、胸骨后疼痛、烧心、反酸嗳气评分比较,P均<0.0005。两组干预后恶心呕吐、胃脘胀痛、胸骨后疼痛、烧心、反酸嗳气评分比较,P均<0.0005。对照组干预前后完全依从、依从变化比较,P均<0.005;对照组干预前后不依从变化比较,P>0.05。观察组干预前后完全依从、依从、不依从变化比较,P均<0.005。两组干预后完全依从、不依从变化比较,P均<0.005;依从变化比较,P>0.05。结论综合护理干预对反流性食管炎从身心到分子水平均有较好的影响,治疗上加用消炎利胆片促进肠蠕动与胆汁排泄有利于疾病的恢复及根治。

Objective To explore the effect of comprehensive nursing intervention on the efficacy, psychology, sleep, compliance, life quality, motilin, gastrin, vasoactive intestinal peptide and inflammatory factors of patients with reflux esophagitis. Methods There were 179 cases of reflux esophagitis patients, 93 males and 86 females. They were randomly divided into two groups and general data comparison between the two groups was P〉0.05. The control group was treated with domperidone and pantoprazole sodium enteric-coated tablets. On the basis of the control group, the observation group was treated with Xiaoyan Lidan tablets for 8 weeks. The control group received routine nursing care. The observation group received comprehensive nursing intervention. The two groups were assessed with self-rating anxiety scale, self-rating depression scale, psycho- logical scale, sleep quality index scale, health status questionnaire score and the venous blood was drawn to detect gastrin, motilin, vasoactive intestinal peptide, interleukin-6,interleukin-8, tumor necrosis factor- α, compliance and typical reflux esophagitis symptom score. The data was analyzed by variance analysis, t test and χ^2 test. Results The scores of anxiety, depression and sleep quality of the control group were compared before and after intervention with P〈0.0005. The scores of those in the observation group were compared before and after intervention with P〈0.0005. The scores of those were compared between the two groups after intervention with P〈0.0005. The scores of social function, body pain, physiological function, vitality, men- tal state and emotional activity in the control group were compared before and after intervention with P〈0.0005. The scores of those in the observation group were compared before and after intervention with P〈0.0005. The scores of those were compared between the two groups after intervention with P〈0.0005. The changes of motilin, gastrin and vasoactive intestinal peptide in the control group before and after intervention were compared with P〈0.0005. The changes of those in the observation group before and after intervention were compared with P〈0.0005. The changes of those were compared between the two groups af- ter intervention with P〈0.0005. The levels of serum interleukin-6, interleukin-8 and tumor necrosis factor-α were compared before and after intervention in the control group with P〈0.0005. The levels of those were compared before and after intervention in the observation group with P〈0.0005. The levels of those were compared between the two groups after intervention with P〈0.0005. The scores of nausea and vomiting, epigastric pain, retrosternal pain, heartburn and regurgitation before and af- ter intervention in the control group were compared with P〈0.0005. The scores of those before and after intervention in the observation group were compared with P〈0.0005. The scores of those between the two groups after intervention were compared with P〈0.0005. The changes of complete compliance and compliance in the control group before and after intervention were compared with P〈0.005; the changes of noncompliance were compared with P〉0.05. The changes of complete compliance, compliance and non-compliance in the observation group before and after intervention were compared with P〈0.005. The changes of complete compliance and non-compliance between the two groups after intervention were compared with P〈 0.005; the changes of compliance were compared with P〉0.05. Conclusion Comprehensive nursing intervention has a good effect on reflux esophagitis from physical and mental level to molecular level. The combination of anti-inflammatory cholagogue tablets to promote intestinal peristalsis and bile excretion is helpful to the recovery of disease.