Epidemiological, Clinical Aspects and Factors Associated with Typical Gastroesophageal Reflux Disease in the General Population of Parakou, Republic of Benin

Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.

Health-related quality of life in gastroesophageal reflux patients with noncardiac chest pain: Emphasis on the role of psychological distress

AIM To investigate the effects of depression and anxiety on health-related quality of life(QoL)in gastroesophageal reflux disease(GERD)patients and those suffering from cardiac(CCP)and noncardiac(NCCP)chest pain in Wuhan,China.METHODS In this cross-sectional study,a total of 358 consecutive patients with GERD were enrolled in Wuhan,China,of which 176 subjects had complaints of chest pain.Those with chest pain underwent coronary angiography and were divided into a CCP group(52 cases)and NCCP group(124 cases).Validated GERD questionnaires were completed,and the 36-item Short-Form Health Survey and Hospital Anxiety/Depression Scale were used for evaluation of Qo L and psychological symptoms,respectively.RESULTS There were similar ratios and levels of depression and anxiety in GERD with NCCP and CCP.However,the QoL was obviously lower in GERD with CCP than NCCP(48.34±17.68 vs 60.21±20.27,P<0.01).In the GERD-NCCP group,rather than the GERD-CCP group,the physical and mental QoL were much poorer in subjects with depression and/or anxiety than those without anxiety or depression.Anxiety and depression had strong negative correlations with both physical and mental health in GERD-NCCP(all P<0.01),but only a weak relationship with mental components of QoL in GERD-CCP.CONCLUSION High levels of anxiety and depression may be more related to the poorer QoL in GERD patients with NCCP than those with CCP.This highlights the importance of evaluation and management of psychological impact for improving QoL in GERD-NCCP patients.

Advances in diagnostic testing for gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) contributes substantially to morbidity and to costs in the United States health care system. The burden of this disease has resulted in attempts at improving diagnosis and characterizing patients. Numerous research and technical advances have enhanced our understanding of both the utility and limitations of a variety of diagnostic modalities. The purpose of this review is to highlight recent advances in GERD diagnostic testing and to discuss their implications for use in clinical practice. Topics addressed include esophageal pH monitoring, impedance testing, symptom association analyses, narrow-band imaging, and histopathology.

Disagreement between symptom-reflux association analysis parameters in pediatric gastroesophageal reflux disease investigation

AIM: To assess the agreement within 3 commonly used symptom-reflux association analysis (SAA) parameters investigating gastroesophageal reflux disease (GERD) in infants. METHODS: Twenty three infants with suspected GERD were included in this study. Symptom index (SI), Symptom sensitivity index (SSI) and symptom association probability (SAP) related to cough and irritability were calculated after 24 h combined pH/multiple intraluminal impedance (MII) monitoring. Through defined cutoff values, SI, SSI and SAP values are differentiated in normal and abnormal, whereas abnormal values point towards gastroesophageal reflux (GER) as the origin of symptoms. We analyzed the correlation and the concordance of the diagnostic classification of these 3 SAA parameters.RESULTS: Evaluating the GER-irritability association, SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 39.2% of the infants. When irritability was taken as a symptom, there was only a poor inter-parameter association between SI and SSI, and between SI and SAP (Kendall’s tau b = 0.37, P < 0.05; Kendall’s tau b = 0.36, P < 0.05, respectively). Evaluating the GER-cough association, SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 52.2% of the patients. When cough was taken as a symptom, only SI and SSI showed a poor inter-parameter association (Kendall’s tau b = 0.33, P < 0.05). CONCLUSION: In infants investigated for suspected GERD with pH/MII-monitoring, SI, SSI and SAP showed a poor inter-parameter association and important dis-agreements in diagnostic classification. These limitations must be taken into consideration when interpreting the results of SAA in infants.

An Alternative Approach to the Gastroesophageal Reflux Disease: Manual Techniques and Nutrition

Gastroesophageal reflux disease (GERD) is a chronic digestive disorder that affects a growing number of people in the world and is one of the most common gastric complaints that prompts an individual to consult a doctor. Heartburn and regurgitation are the most predominant esophageal symptoms of GERD, but patients with the disease may also have extra esophageal symptoms, such as epigastric pain, bronchospasm, and chronic cough. All of these symptoms may compromise health-related quality of life with modification of eating habits and sleep pattern that have a great impact on the normal daily. Furthermore, GERD is a multifactorial disease that can be complicated and difficult to treat. Mechanical, chemical, physiopathologic, and functional factors that predispose patients to the disease are still under investigation. A simple treatment plan for manual therapists is presented based on current evidence-based literature;it is designed to reduce symptoms of GERD through somatovisceral approach and the nutrition.

Effects of herbal medicine in gastroesophageal reflux disease symptoms: a systematic review and meta-analysis

Background: Pyrosis and regurgitation are the cardinal symptoms of gastroesophageal reflux disease. Severalherbs have been used for treating gastrointestinal disorders worldwide. This systematic review was conducted toinvestigate the effects of medicinal herbs on gastroesophageal reflux disease and adverse events. Methods:MEDLINE (via PubMed;The United States National Library of Medicine, USA), Scopus, ScienceDirect,Cochrane Central Register of Controlled Trials, Web of Science, Magiran, and Scientific Information Databasewere systematically searched for human studies, without a time frame, using medical subject heading terms such as“gastroesophageal reflux disease”, “reflux”, “esophagitis” and “herbs”. Manual searches completed the electronicsearches. Results: Thirteen randomized controlled trials were identified, including 1,164 participants from 1,509publications. In comparing herbal medicine to placebo, there were no significant differences in terms of heartburn(P = 0.23 and 0.48), epigastric or abdominal pain (P = 0.35), reflux syndrome (P = 0.12), and effective rate (P =0.60), but there was a significant difference in terms of acid regurgitation (P = 0.01). In comparing herbal medicineto drugs, there was a significant difference in terms of effective rate (P = 0.001), and there was one trial thatreported a significant difference in terms of epigastric pain (P = 0.00001). Also, in comparing herbal medicine todrugs, there were no significant differences in terms of acid regurgitation (P = 0.39). Conclusion: Thismeta-analysis showed that herbal medicines are effective in treating gastroesophageal reflux disease. Furtherstandardized researches with a large-scale, multicenter, and rigorous design are needed.

Prevalence of gastroesophageal reflux symptoms in a large unselected general population in Japan

AIM:To examine the prevalence of gastroesophageal reflux disease (GERD) symptoms in a large unselected general population in Japan. METHODS: In Japan, mature adults are offered regular check-ups for the prevention of gastric cancer. A notice was sent by mail to all inhabitants aged > 40 years. A total of 160 983 Japanese (60 774 male, 100 209 female; mean age 61.9 years) who underwent a stomach check up were enrolled in this study. In addition, from these 160 983 subjects, we randomly selected a total of 82 894 (34 275 male, 48 619 female; mean age 62.4 years) to evaluate the prevalence of abdominal pain. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a 1 mo period. RESULTS: The respective prevalences of the symptoms in males and females were: heartburn, 15.8% vs 20.7%; dysphagia, 5.4% vs 7.8%; and abdominal pain, 6.6% vs 9.6%. Among these symptoms, heartburn was significantly high compared with the other symptoms, and the prevalence of heartburn was significantly more frequent in females than in males in the 60-89-year agegroup. Dysphagia was also significantly more frequent in female patients. CONCLUSION: The prevalence of typical GERD symptoms (heartburn) was high, at about 20% of the Japan population, and the frequency was especially high in females in the 60-89 year age group.

Detection of reflux-symptom association in children with esophageal atresia by video-pH-impedance study

BACKGROUND Children with esophageal atresia(EA)have risk of gastroesophageal reflux disease(GERD),suggesting reflux monitoring for prompt management.AIM To evaluate GERD in children with EA and specific symptom association from combined Video with Multichannel Intraluminal Impedance and pH(MII-pH)study.METHODS Children diagnosed with EA with suspected GERD and followed up at King Chulalongkorn Memorial Hospital between January 2000 and December 2018 were prospectively studied.All underwent esophagogastroduodenoscopy with esophageal biopsy and Video MII-pH study on the same day.Symptoms of GERD which included both esophageal and extra-esophageal symptom were recorded from video monitoring and abnormal reflux from MII-pH study based on the statement from the European Paediatric Impedance Group.Prevalence of GERD was also reported by using histopathology as a gold standard.Endoscopic appearance was recorded using Los Angeles Classification and esophagitis severity was graded using Esohisto criteria.RESULTS Fifteen children were recruited with age of 3.1(2.2,9.8)years(40%,male)and the common type was C(93.3%).The symptoms recorded were cough(75.2%),vomiting(15.2%),irritability or unexplained crying(7.6%)and dysphagia(1.9%)with the symptom-reflux association of 45.7%,89%,71%and 0%,respectively.There were abnormal endoscopic appearance in 52.9%,esophagitis in 64.7%and high reflux score in 47.1%.Video MII-pH study has high diagnostic value with the sensitivity,specificity and accuracy of 72.7%,100%and 82.4%,respectively.CONCLUSION Prevalence of GERD in children with EA was high.Video MII-pH study to detect GERD in children with EA had high diagnostic value with the trend of specific symptom association.

基于“心胃相关”理论探析胃食管反流病相关性胸痛病机

胃食管反流病是临床上一种常见的疾病,胃食管反流病相关性胸痛是非心源性胸痛最常见的食管源性病因,与心血管系统疾病有关胸痛极易混淆,在临床上需认真鉴别,以便明确诊疗。心与胃位置相邻,经络相通,生理与病理上相互联系,心在脾胃病的辨证论治中具有重要作用。“心胃相关”理论为胃食管反流病相关性胸痛提供了理论基础。脾胃虚弱,推动无力,气血生化乏源,心失所养;脾虚,肝木乘克脾土,肝胃不和,气郁日久,郁而化热,热扰心神,胃气挟火热上逆,日久耗伤阴血。因虚致瘀或气滞血瘀,不通则痛,胸脉瘀阻,引起胸痛。本文基于“心胃相关”理论从“虚、郁、瘀”角度出发,探讨胃食管反流病相关性胸痛,为临床诊疗提供更好的思路。

谢晶日教授运用“疏郁通降”法治疗胃食管反流病经验撷英

阐述谢晶日教授运用“疏郁通降”法治疗胃食管反流病的经验,谢晶日教授临床治疗胃食管返流病的常用治法有疏肝理气、抑酸止痛、通畅腑气、和降胃气及固护脾胃,通过运用以上治疗方法,临床上可以减少胃食管反流病的发生率,提高患者生活质量,并附验案1则。

胃食管反流病与偏头痛的因果关系:一项孟德尔随机化研究

目的采用两样本孟德尔随机化方法探究胃食管反流病(gastroesophageal reflux disease,GERD)与偏头痛之间的因果关系。方法研究数据来自GWAS数据库,其中GERD数据包含602604例样本,偏头痛数据包含462933例样本,使用逆方差加权法、MR-Egger和加权中值法三种孟德尔随机化分析方法,采用OR值评估GERD与偏头痛之间的因果关系。同时采用Cochran′s Q检验、MR-Egger截距、留一法(leave-one-out)和漏斗图4种方法进行敏感性分析。结果逆方差加权法结果显示,GERD与偏头痛之间存在正向因果关系(P=0.003),敏感性分析未显示统计多效性。结论孟德尔随机化分析支持GERD与偏头痛的正向因果关系,为偏头痛的预防和治疗提供了参考依据。

基于孟德尔随机化分析胃食管反流病与牙龈疼痛的关系

目的通过采用两样本孟德尔随机化(MR)分析,研究胃食管反流病与牙龈疼痛之间的因果关系。方法从已发表的全基因组关联研究中获得与牙龈疼痛相关的单核苷酸多态性,从已发表的全基因组关联研究中获得与胃食管反流病相关的汇总水平遗传数据,研究主要使用逆方差加权法(IVW)进行两样本MR分析。使用Cochran中Q统计学方法来评估结果的异质性,同时采用MR-Egger检测水平多效性,“留一法”进行敏感性分析。结果胃食管反流病对牙龈疼痛呈现正因果效应(OR=1.009,95%CI:1.006~1.012,P<0.001)。结论胃食管反流病的遗传性增加与发生牙龈疼痛风险的增加显著相关。深入理解胃食管反流病和牙龈疼痛之间的正相关关系对于胃食管反流病的临床治疗和患者的口腔健康管理具有重要意义。

Origin of and therapeutic approach to cardiac syndrome X:Results of the proton pump inhibitor therapy for angina-like lingering pain trial (PITFALL trial)

AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome X (CSX) as a subform of non-cardiac chest pain (NCCP). METHODS: We investigated 114 patients with CSX using symptom questionnaires. A subgroup of these patients were investigated regarding upper gastrointestinal disorders (GIs) and treated with PPI. Patients not willing to participate in investigation and treatment served as control group. RESULTS: Thirty-six patients denied any residual symptoms and were not further evaluated. After informed consent in 27 of the remaining 78 patients, we determined the prevalence of disorders of the upper GI tract and quantifi ed the effect of treatment with pantoprazole. We found a high prevalence of gastroenterological pathologies (26/27 patients, 97%)with gastritis, gastroesophageal reflux disease (GERD) and acid reflux as the most common associated disorders. If treated according to the study protocol, these patients showed a significant improvement in the symptom score. Patients treated by primary care physicians, not according to the study protocol had a minor response to treatment (n = 19, -43%), while patients not treated at all (n = 26) had no improvement of symptoms (-0%). CONCLUSION: Disorders of the upper GI tract are a frequent origin of CSX in a German population and can be treated with pantoprazole if given for a longer period.

食管测压联合食管24 h pH监测对胃食管反流相关性胸痛的诊断价值

目的探讨食管测压联合食管24 h pH监测对胃食管反流相关性胸痛的诊断价值。方法选取通辽市医院2017年6月至2021年12月接收的疑似胃食管反流引起的相关性胸痛患者145例,男92例,女53例,采用食管测压联合食管24 h pH进行监测,以是否胃食管反流分为胃食管反流组与无反流组。收集两组患者的年龄、性别、蠕动收缩百分数、pH<4反流次数、最长反流持续时间等资料,采用t、χ2检验进行统计比较,通过多因素logistic回归分析、受试者工作特征曲线(ROC)分析上述指标与胃食管反流相关性胸痛的相关性。结果145例疑似胃食管反流相关性胸痛患者,经诊断为胃食管返流36例,无返流109例。经多因素logistic回归分析发现,蠕动收缩百分数、pH<4反流次数、最长反流持续时间均是胃食管反流引起的相关性胸痛的影响因素[比值比(OR)=3.155、2.998、3.459,P=0.003、0.012、0.001]。经ROC分析,食管测压、pH<4反流次数、最长反流持续时间联合预测胃食管反流引起的相关性胸痛的灵敏度与曲线下面积(AUC)均高于各指标单独预测时(P=0.001、0.001、0.004),联合预测的特异度与各指标单独预测时差异无统计学意义(P=0.852)。结论食管测压联合食管24 h pH监测对于胃食管反流引起的相关性胸痛的诊断、治疗具有重要意义,值得临床推广应用。

基于验案数据挖掘探究名中医连建伟治疗胃食管反流病的用药规律

[目的]运用数据挖掘技术对连建伟教授治疗胃食管反流病验案的用药规律进行分析。[方法]运用中医传承辅助系统(V2.5),对2017年10月至2020年10月在连建伟名中医工作室就诊的胃食管反流病患者的用药进行频次统计、药物关联规则、复杂系统熵聚类等分析。[结果]共纳入胃食管反流病患者141例,男性61例、女性80例,50~59岁人数最多,病案274则。高频药物(频次≥30)共32种,核心药物由柴胡、郁金、丹参、陈皮、茯苓、甘草组成,是逍遥散加减方。药物四气以温、平、寒为主,五味以苦、甘、辛居多,归经多归脾、肝、胃经。熵聚类分析共提取出核心组合10组,新方5个。[结论]连教授治疗胃食管反流病时,常取逍遥散加减以疏肝健脾,用药寒温并用,补而不滞,同时注重随证治之,多随证加入清热、活血、消食、祛湿之法。

胃食管反流性胸痛的临床探讨

目的 探讨胃食管反流性胸痛 (GERCP)的临床特征及其诊断和治疗。方法 对 2 7例冠状动脉造影、动态心电图和胸片正常的非心源性胸痛 (NCCP)患者进行胃镜检查及 2 4h食管 pH监测 ,并利用症状相关性概率 (SAP)分析胸痛与胃食管反流 (GER)的相关性 ,对Demeester总积分≥ 14 .72和 (或 )SAP≥ 75 %的患者进行为期 4周的奥美拉唑 (4 0mg/d ,分 2次服用 )试验性抗反流治疗。结果 2 7例NCCP患者中 ,有 13例Demeester总积分≥ 14 .72 ,14例Demeester总积分 <14 .72中 6例SAP≥ 75 % ,这 19例患者诊断为GERCP ;应用奥美拉唑完成试验性抗反流治疗后 ,15例患者胸痛消失 ,其余 4例对试验性抗反流治疗反应较差或无效。结论 GER是不明原因胸痛的一个重要的独立原因 ,2 4h食管 pH监测结合SAP有助于GERCP的诊断 ;应用奥美拉唑试验性抗反流治疗

胃食管反流病相关非心源性胸痛患者临床特点、心理状况及生活质量调查

目的:探讨胃食管反流病(GERD)非心源性胸痛(NCCP)患者的临床特点,调查NCCP患者的食管外症状、精神心理状况及生活质量,为NCCP的诊治提供依据。方法:对连续入组的206例GERD患者进行问卷调查,内容包括一般人口学资料、疼痛部位和疼痛程度评分(VAS)、食管外症状、反流性疾病问卷(RDQ)、焦虑量表(SAS)和抑郁量表(SDS)以及简明健康调查量表(SF-36);结合胃镜检查、反流症状评分将GERD患者分为GERD-NCCP组和GERD-非NCCP组进行比较。结果:①NCCP患者中最多见的胸痛部位是胸骨后、剑突下(42.1%);疼痛程度最明显的是胸骨后放射至后背痛(5.8±1.7);②NCCP组患者RDQ评分显著高于非NCCP组(P<0.01),NCCP组食管外症状发生率为35.7%,普遍高于非NCCP组的29.1%,咽部异物感、咽喉炎发生率分别为50.8%、38.8%,50.8%、30.0%,差异有统计学意义(P<0.05)。③NCCP组患者焦虑和抑郁评分显著高于中国常模(P<0.01),亦显著高于非NCCP组(P<0.01)。④NCCP组SF-36量表8个维度,除社会功能外,均显著低于中国常模(P<0.01),组间比较,NCCP组各项积分均低于非NCCP组,其中身体疼痛、生命活力、精神健康3个维度积分下降更为显著(P<0.05)。结论:NCCP患者常伴有心理状态改变和生活质量下降,胸痛的程度、部位以及对疼痛的恐惧均对患者有一定影响。提示对NCCP患者的治疗应从心理和生理两方面协同,可全面改善其症状和生活质量。

针刺督脉背段T3~T12棘突下治疗胃食管反流性胸痛临床研究

目的:研究胃食管反流性胸痛的患者针刺督脉背段T 3~T 12棘突下穴位及非穴位前后压痛变化规律,并观察其疗效。方法:根据纳入标准收集60例胃食管反流性胸痛患者,按照随机数字表法分为针刺组30例、西药组30例。针刺组予针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗,隔日1次,西药组予雷贝拉唑钠肠溶胶囊口服,每次20 mg,1日两次,治疗疗程为8周。比较两组患者胃食管反流病问卷(RDQ)评分以及其中的胸痛评分在治疗前后的变化情况,比较T 3~T 12棘突下穴位及非穴位压痛阈值的变化情况,观察两组患者在治疗前后的临床疗效。结果:①治疗后针刺组与西药组RDQ评分以及其中的胸痛评分较治疗前均有明显改善(P<0.01),且针刺组较西药组改善更为明显(P<0.01);②西药组治疗后T 4、T 5、T 7、T 8、T 9棘突下的压痛阈值较治疗前降低(P<0.05或P<0.01),针刺组治疗后T 5~T 12棘突下的压痛阈值较治疗前明显提高(P<0.05或P<0.01),治疗后针刺组与西药组进行比较,针刺组在T 6~T 9棘突下的穴位压痛阈值高于西药组较明显(P<0.05);③针刺组愈显率为76.67%(23/30),西药组为30.00%(9/30),临床疗效针刺组优于西药组(P<0.01)。结论:针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗胃食管反流性胸痛较西药雷贝拉唑钠肠溶胶囊更优,可以明显减轻胸痛程度。

疏肝和胃方治疗58例胃食管反流病相关性胸痛临床观察

目的:观察胃食管反流病相关性胸痛的中医证型分布特点及疏肝和胃方治疗本病的临床疗效。方法:对58例胃食管反流病相关性胸痛患者进行中医辨证分型与胃镜下分级,分析两者的关系。以中药疏肝和胃方随证加减治疗8周后,观察胸痛症状积分与其他临床症状积分的改善情况。结果:①属肝胃郁热证39例(67.24%),胆热犯胃证4例(6.90%),气郁痰阻证9例(15.52%),中虚气逆证6例(10.34%)。胃镜下分级在中医证型分布中无显著性差异(P>0.05)。②治疗前后胸痛症状积分及其他临床症状积分均有显著性差异(P<0.01)。③胸痛症状改善显效率是96.55%,临床症状改善显效率是87.93%。结论:胃食管反流病相关性胸痛以肝胃郁热证多见,其次为气郁痰阻证;其中医证型分布与胃镜下分级无明显关系;疏肝和胃方能有效改善本病的胸痛症状及其他临床症状。

慢性非心源性胸痛的诊治

目的探讨发生慢性非心源性胸痛(NCCP)的可能原因,指导临床诊治。方法选择经心血管专科检查排除缺血性心脏疾病的慢性胸痛患者33例,采用电子胃镜、pH测定、心电图检测,给予质子泵抑制剂(PPI)治疗,并进行精神状况评估,将检查结果与患者主观症状记录进行对照分析。结果 25例患者(75.8%)在出现主观症状时同时出现胃食管反流病(GERD),5例患者(15.2%)在出现主观症状时同时出现GERD及心电图ST-T下移,15例患者(45.5%)伴不同程度焦虑、抑郁等症状。经PPI等综合治疗后,31例患者(93.9%)胸痛症状缓解或消失。结论 NCCP以GERD最为多见,可采取以PPI为主的综合治疗措施;GERD患者在食管酸度下降引起主观症状同时可出现心电图改变,经PPI治疗后,胸痛改善,同时心电图改变亦可消失;NCCP往往合并不同程度精神症状,应注意评估其精神心理状况,合理疏导,必要时辅助使用精神类药物,以利更大限度地缓解症状。