癔球症患者的临床发病学-精神心理特征：附559例病例分析

The clinical and psychological characteristic of patients with globus sensation: An analysis of 559 cases

目的阐明耳鼻喉科门诊癔球症患者的临床发病学-精神心理特征。方法采用罗马Ⅲ标准,对2014年5月至2015年5月就诊于广州市第一人民医院耳鼻喉科门诊的癔球症患者的病程、格拉斯哥爱丁堡咽喉症状评分量表(Glasgow Edinburgh Throat Scale,GETS)、汉密尔顿焦虑量表(Hamilton Rating Scale of Anxiety,HAMA)、汉密尔顿抑郁量表(Hamilton Rating Scale of Depression,HAMD)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)等进行问卷调查。结果癔球症占耳鼻喉科门诊就诊患者的1.28%,女性稍多(59.75%),夏秋季多发,35~54岁为发病高峰年龄。39%的患者诉发病前或就诊时伴有压力或负性应激事件,50.97%伴有焦虑状态,27.31%伴有抑郁状态,45.38%伴有睡眠障碍。仅5.8%的患者认为耳鼻喉科常规治疗及抑酸治疗有效,40%的患者因压力或负性应激事件诱发,近50%的患者就诊10次以上。结论耳鼻喉科门诊癔球症患者并非少见,多伴发焦虑抑郁状态及睡眠障碍,常规疗法不佳致患者反复就诊。

Objective To investigate the clinical epidemiology and psychological characteristics of patients with globus sensation in ENT clinics. Methods Using the Rome III criterion, 559 globus sensation out- patients in ENT clinic at Guangzhou First Municipal People＇s Hospital from May 12, 2014 to May 12, 2015 were required to conduct the questionnaire survey, including course of disease, Glasgow Edinburgh Throat Scale （GETS）, Hamilton Rating Scale of Anxiety/Depression （HAMA/HAMD） and Pittsburgh Sleep Quality Index （PSQI） etc. Results The percentage of globus sensation patients was 1.28% among all first visit outpatients in ENT clinic during the investigation period. There were more female than male （59.75% vs 40.25%）. The amounts of office visits in summer and autumn were higher than in winter and spring（P 〈 0.05）. The peak age of disease onset was 35 - 54 years old. 39.00% of globus sensation patients encountered stress or negative stressful events prior to or during the office visits. Other chief complaints included anxiety （50.97%）, depression （27.31%） and sleep disorder （45.38%）. About 50% patients had office visits over 10 times, however, only 5.8% of the globus sensation patients believed the effects of the conventional ENT treatment and antacid therapy. The symptoms were triggered by stress or negative events Jn nearly 40% patients. Conclusion Globus sensation patients are not uncommon in ENT clinics. The patients may present with anxiety, depression and sleep disorders. Frequent clinic visits may be related to suboptimal conventional treatment.