功能性消化不良抑郁、焦虑的发生情况及其对患者生活质量与疗效的影响.docVIP

功能性消化不良抑郁、焦虑的发生情况及其对患者生活质量和疗效的影响 　　　作者：陈仕武，陈刚，张晓，殷先锋，黄振銮，邵昌发，崔桂林 作者单位：解放军驻香港部队医院 综合临床科，广东 深圳 518048;解放军第422医院 内一科，广东 湛江 524005 　　【摘要】 目的 探讨功能性消化不良(FD)抑郁、焦虑发生情况及对患者生活质量(QOL)及疗效的影响。方法 1 256例FD患者，使用综合医院焦虑、抑郁量表(HADS)进行心理自评。随机抽取30例无抑郁和(或)焦虑症状的患者,分两次按抑郁和(或)焦虑症状随机抽取30例，组成A、B、C组，三组予以医疗结算简易表(Medical Outcomes Study Short Form questions 36 SF36)对QOL自评。B组予以阿米替林12.5 mg，3次/d，奥美拉唑20 mg，2次/d，莫沙比利5 mg，3次/d，口服，A、C组予以奥美拉唑20 mg，2次/d，莫沙比利5 mg，3次/d，口服。疗程为8周，治疗后行HADS及SF一36评分。并记录评价治疗前后及每周躯体症状情况。结果 FD患者抑郁和(或)焦虑患病率为56.37%;并抑郁和(或)焦虑症状的FD患者QOL与无抑郁、焦虑的FD患者差异有统计学意义(P0.01)：A、B组治疗后，躯体症状及QOL均改善差异有统计学意义(P0.01或P0.05)，C组躯体症状也有显著改善(P0.01)，其QOL无明显改善(P0.05);治疗后A、B组与C组在躯体症状和QOL上差异有统计学意义(P0.01)，A组与B组间差异无统计学意义(P0.05);治疗后B组和C组抑郁、焦虑症状均有改善(P0.01)，但B组明显高于C组(P0.01)。结论 FD患者的抑郁和(或)焦虑症状患病率较高，其对FD患者的QOL有明显影响，抗抑郁药治疗能显著改善精神和躯体两方面症状，并能显著提高患者的QOL。 　　【关键词】 功能性消化不良;抑郁;焦虑;生活质量;抗抑郁药 　　Analysis of the Occurrence of Functional Dyspepsia by Depression Symptom，Anxiety Symptom and Its Effect on the Quality of Life and Curative Effect of the Patients 　　Chen Shiwu，Chen Gang，Zhang Xiao，Yin Xianfeng，Huang Zhenluan，Shao Changfa，Cui Guilin 　　(Department of Comprehensive Clinical , Military Hospital of PLA Forces Hong Kong，Shenzhen 518048, China;Department of Medical ，PLA No. 422 Hospital，Zhanjiang 524005，China) 　　Abstract： Objective To explore the occurrence of functional dyspepsia by depression symptom，anxiety symptom and its effect on the quality of life and curative effect of the patients.Methods The Hospital anxiety and depressive scale(HADS) was applied to psychological self-analysis of 1256 cases of FD.30 patients were randomly selected by sex into A groups from the FD patients who had no depression symptom and(or)anxiety symptom.30 patients were randomly selected by sex into B groups from the FD patients who had depression symptom and(or)anxiety symptom, the same is as C groups.The SF36(Medical Outcomes Study Short Form questions 36)was applied to selfanalysis the QOL of the 90 patients in three