系统性心理干预联合药物治疗消化性溃疡的临床疗效

The clinical efficacy observation of systematic psychological intervention and drug therapy for peptic ulcer

目的观察系统性心理干预联合药物治疗消化性溃疡的临床疗效。方法前瞻性选择2017年12月至2019年7月湖北省兴山县人民医院收治的182例消化性溃疡患者,按照随机数字表法分为对照组和研究组2组,各组91例。对照组患者采用奥美拉唑肠溶胶囊、阿莫西林胶囊、克拉霉素片、胶体果胶铋颗粒等四联疗法。研究组患者在此基础上由主管医师和执业心理医师给予系统性心理干预。停药4周后,比较两组患者临床症状(包括胃脘疼痛、胃脘胀满、泛吐清水、口淡无味、纳差、气短)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、溃疡愈合率及幽门螺杆菌清除率及临床疗效。结果治疗后对照组42例患者(47.2%)伴有相关临床症状,研究组24例患者(27.3%)伴有临床症状,两组比较差异有统计学意义(P<0.01)。治疗后研究组患者SAS及SDS评分均低于对照组患者,且差异均有统计学意义(P均<0.05)。研究组患者溃疡愈合率、幽门螺杆菌清除率均高于对照组患者,且差异均有统计学意义(P均<0.05)。研究组患者治疗有效率也高于对照组患者,且差异有统计学意义(P<0.05)。结论与单纯药物治疗比较,系统性心理干预联合药物治疗消化性溃疡的临床疗效更为显著,值得临床进一步推广。

Objective To observe the clinical efficacy of systematic psychological intervention combined with drugs in the treatment of peptic ulcer. Methods From December 2017 to July 2019, 182 patients with peptic ulcer admitted to Xingshan People’s Hospital were prospectively selected. The patients were divided into control group and research groups, with 91 patients in each group. Participants in the control group were treated with quadri-combination therapy including omeprazole enteric-coated capsule, amoxicillin capsule, clarithromycin tablet and colloidal pectin bismuth. On the basis, the participants in the research group were treated with systematic psychological intervention by competent physician and licensed psychologist. Four weeks after drug withdrawal, clinical symptoms(including epigastric pain, epigastric distention, vomiting water,tastelessness, poor appetite and short breath), Self-Rating Anxiety Scale(SAS) score, Self-Rating Depression Scale(SDS) score, ulcer healing rate and Helicobacter pylori clearance rate and clinical efficacy were compared between the two groups. Results A total of 42 participants(47.2%) in the control group were accompanied with relative clinical symptoms and 24 participants(27.3%) in the research group were accompanied with relative clinical symptoms, with significant difference(P<0.01). By contrast with control group, the SAS and SDS scores of participants in the research group were obviously lower(both P<0.05). Compared with the control group, the ulcer healing rate and Helicobacter pylori clearance rate in the research group were obviously higher(both P<0.05). Compared with the control group, the clinical efficacy of the research group was higher, with significant difference(P<0.05). Conclusion In contrast with simple drug therapy, systematic psychological intervention combined with drug treatment for peptic ulcer is more significant in clinical effect, worth of further clinical promotion.