功能性消化不良伴精神心理异常83例临床分析

Clinical analysis of functional dyspepsia with psychosocial abnormality in 83 cases

目的评估功能性消化不良(FD)伴精神心理异常患者性别、诱因、年龄、学历、职业及消化不良症状评分与心理异常各项目的关系。方法收集2017年7月至2018年3月于中国医科大学附属盛京医院消化内科门诊就诊符合罗马Ⅳ诊断标准的功能性消化不良且SCL-90测评存在精神心理异常的患者83例,并对诱因、性别、年龄、学历、职业、消化不良症状程度、心理测评各项目的关系进行分析。结果 (1)诱因方面女性多以家庭因素为主,男性以工作因素为主,存在性别差异(P<0.05)。(2)女性抑郁评分高于男性(P<0.05)。(3)消化不良症状评分与患者SCL-90阳性总分呈正向相关(Spearmanρ=0.425,P<0.05)。(4)躯体化、强迫状态及其他(包括饮食、睡眠)的出现频率最高(躯体化87.9%,强迫状态87.9%,其他83.1%)。结论功能性消化不良伴精神心理异常的患者,女性多见,诱因以家庭因素为主,男性以工作因素为主。FD患者中女性抑郁程度高于男性。心理测评阳性总分越高,消化不良症状越严重。FD伴精神心理异常患者主要表现为躯体化、强迫状态及饮食、睡眠障碍。

Objective To evaluate the relationship between gender,inducement,age,education background,occupation as well as dyspepsia symptom score and psychological abnormalities in patients with functional dyspepsia and psychosocial abnormality. Methods We collected 83 patients with functional dyspepsia who met the criteria for diagnosis of Rome Ⅳ and with psychosocial abnormality by SCL-90 assessment from July 2017 to March 2018,who went to the Department of Gastroenterology,Shengjing Hospital Affiliated to China Medical University to analyze the relationship among inducement,sex,age,education background,occupation,degree of dyspepsia symptom and psychological evaluation. Results(1)In terms of inducement,for the female family,factors were the main factor,while work factors were the main factor for male,and there was a gender difference(P<0.05).(2)The depression score of female was higher than that of male(P<0.05).(3)The score of dyspepsia was positively correlated with the total score of SCL-90(Spearman rho=0.425,P<0.05).(4)Somatization,compulsive state and others(including diet,sleep)were the highest frequency(somatization 87.9%,compulsive state87.9%,the others 83.1%). Conclusion Functional dyspepsia accompanied by psychosocial abnormality is more common in the female, and the family factors are the main cause, while mork factors are the main cause in the male.The degree of depression in FD patients is higher in women than in men.The higher the positive total score,the more serious the indigestion symptoms.FD patients with psychopathosocial abonoirmality have somatization and compulsion,eating and sleeping disorders as main manifestations.