摘要
目的探讨抑郁、焦虑症状对非糜烂性胃食管反流病(non-erosive reflux disease,NERD)生活质量(quality of life,QOL)的影响及药物治疗观察。方法对727例NERD患者应用综合医院焦虑、抑郁量表(the Hospital anxiety and depressive scale,HADS)进行心理测评,随机抽取30例不合并抑郁、焦虑症状NERD为A组,30例合并抑郁和/或焦虑症状NERD为B组,30例合并抑郁和/或焦虑症状NERD为C组。A组、C组予奥美拉唑20mg,2/d,西沙比利10mg,3/d,口服;B组在A、C组用药基础上给予阿米替林12.5mg,3/d,口服,疗程为8周,各组在治疗前后予以医疗结算简易表(Medi-cal Outcomes Study Short Form questions36,SF-36)对QOL自评,并于治疗后2、4、6、8周观察反酸、烧心、反胃、胸骨后疼痛及抑郁和/或焦虑症状的缓解情况。结果 NERD患者抑郁和/或焦虑患病率为52.68%;A组、B组治疗后,躯体症状及QOL均改善差异有统计学意义(P<0.01或P<0.05),C组躯体症状和部分QOL维度改善差异亦有统计学意义(P<0.01),但QOL中部分维度改善差异无统计学意义(P>0.05);治疗后B组和C组抑郁、焦虑症状均有改善,B组有效率明显高于C组(P<0.01)。结论 NERD患者有较高的抑郁和/或焦虑症状患病率,其对NERD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。
Objective To investigate the role of depression and anxiety symptoms in the quality of life （QOL） of non-erosive reflux disease （NERD） and the effect of drugs on NERD.Methods The hospital anxiety and depressive scale （HADS） was applied to psychological analysis of 727 cases of NERD.30 NERD patients who had no depression symptom and （or） anxiety symptom were randomly assigned into group A.60 NERD patients who had depression symptom and （or） anxiety symptom were randomly assigned into groups B and C （each n=30）.The patients of group B were given amitriptyline 12.5 mg three times daily,omeprazole 20 mg twice daily,and mosapride 10 mg three times daily.60 patients of groups A and C were given omeprazole 20mg twice daily and mosapride 10 mg three times daily.The SF-36 （Medical Outcomes Study Short Form questions 36） was applied to analyzing the QOL of the 90 patients in three groups by themselves before and after treatment.The major clinical symptoms,depressive symptom and （or） anxiety symptom were evaluated before and after 2,4,6 and 8 weeks of treatment.Results The incidence rate of depressive symptom and （or） anxiety symptom in NERD patients was 52.68%.After the treatment,the major clinical symptoms and QOL of groups A and B were both improved,and there were statistically significant differences between before and after treatment（P〈0.01 or P〈0.05）.There were statistically significant differences（P0.01）in major clinical symptoms and a part of QOL in group C before and after treatment,but other part of QOL showed no statistical difference（P〉0.05）.After the treatment,the depression symptom and （or） anxiety symptom of groups B and C were both improved,but the effective rate of group B was significantly higher than that of group C（P〈0.01）.Conclusions The incidence rate of depression and （or） anxiety symptoms is high in NERD patients.The depression and （or） anxiety symptoms can significantly influence the QOL of NERD.Antidepressant medications are effective in relieving somatic and psychological symptoms,and can significantly improve the QOL of NERD.
出处
《实用预防医学》
CAS
2010年第6期1074-1077,共4页
Practical Preventive Medicine
