【摘要】 目的研究胃食管反流病(GERD)不同亚型患者的精神心理异常及其对患者自然病史的影响。方法对临床考虑GERD的患者行胃镜和24 h胃食管pH值监测.询问并填写症状问卷。调查反流症状的发作频率和严重程度,患者自填SCL-90评分表。对初诊后1年以上的患者再次进行症状和治疗情况询问。结果115例患者随访12～37个月,平均(18.0±6.1)个月。GERD患者躯体化、焦虑、抑郁、强迫和精神病性因子分及异常项目数高于正常值;反流性食管炎(RE)患者躯体化、焦虑、抑郁、强迫和异常项目数等项高于正常值;非糜烂性胃食管反流病(NERD)患者躯体化、精神病性和异常项目数高于正常值,上述差异均有统计学意义(P<0.05)。在无病理性酸反流的NERD患者中,随访时有症状组的躯体化、强追、人际关系敏感、偏执、其他及总分明显高于无症状组。在GERD患者中.持续用药组的躯体化、抑郁、敌对、偏执、精神病性、其他等6项因子分和总分均明显高于非用药组。结论GERD患者总体及其不同亚型均有多种异常精神心理特征。在无病理性酸反流的NERD患者中,精神心理异常是影响其长期症状有无的重要因素。精神心理异常的患者宜采用持续性药物治疗方式。更多还原

【Abstract】 Objective To investigate the effects of abnormal psychological factors on patients with different subtypes of gastroesophageal reflux disease(GERD)and on their natural history.Methods Patients with GERD symptoms were underwent 24 hour esophageal pH monitoring and endoscopy.They were enquired about frequency and severity of reflex symptoms and other informations,and filled in the Symptom Checklist 90(SCL-90).Twelve months later,they were enquired again about their symptoms and medication.Results One hundred and fifteen patients were followed up for(18.0±6.1)months (ranged from 12 to 37 months).The values of psychosomatic parameters including somatic,anxious, depression,compulsory and psychiatric scores in patients with GERD and RE were higer than normal values(both P<0.05).The values of somatic,psychiatric in patients with non-erosive reflux disease (NERD)were also higher than normal values(P<0.05).The psychosomatic parameters including so- matic,compulsory and stubborn in patients with NERD who had symptoms during the follow up,were higher than those in asymptom patients.The above parameters in patients who need receiving continuos medication were significantly higher than those without.Conclusions The GERD patients are found to have psychosomatic abnormality.These abnormalities involve in the long-term symptoms of NERD pa- tients with negative acid monitoring.Patients with psychosomatic abnormalities are suitable for receiving continuous medication.更多还原