CAJ | 학술논문

目的探讨心理因素(焦虑和抑郁)对功能性胃肠病(FGID)患者生活质量的影响.方法选取符合罗马Ⅲ诊断标准的FGID患者450例(功能性腹泻150例、肠易激综合征150例、功能性便秘150例)为研究组,另选取150例器质性胃肠疾病患者(阳性对照组)和150健康体检者(阴性对照组).3组研究对象均使用综合医院抑郁焦虑量表(HAD)进行自评和国人普适量表(QOL-35)进行生活质量评分.HAD评分≥9分者,再由专业的心理或精神科医生使用Hamilton焦虑量表(HAMA)和Hamilton抑郁量表(HAMD)进行心理评分.结果研究组、阳性对照组、阴性对照组HAD≥9分者分别占32.7%、17.3%和4.0%,研究组与阳性对照组、阴性对照组比较差异有统计学意义(χ2值分别为27.15和47.16,P＜0.01).3组存在焦虑或抑郁症状者,焦虑或抑郁障碍的患病率分别为70.6%、38.5%和0,研究组与阳性对照组、阴性对照组比较差异有统计学意义(χ2值分别为7.52和9.26,P＜0.01).33.8%的FGID患者生活质量下降,7.8%的患者生活质量明显下降,16.7%的阳性对照和4.7%的阴性对照生活质量下降.在研究组HAD≥9分者(143例)中,不同QOL-35评分者HAD、HAMA、HAMD评分不同,差异有统计学意义(P＜0.05);QOL-35评分越低,HAD、HAMA、HAMD评分越高.结论近1/3的FGID患者存在抑郁或焦虑症状,且FGID患者抑郁或焦虑症状发生率显著高于器质性胃肠疾病患者和健康者;FGID患者的生活质量下降,且生活质量越低,患者的焦虑或抑郁越严重.
목적 탐토심리인소(초필화억욱)대공능성위장병(FGID)환자생활질량적영향.방법 선취부합라마Ⅲ진단표준적FGID환자450례(공능성복사150례、장역격종합정150례、공능성편비150례)위연구조,령선취150례기질성위장질병환자(양성대조조)화150건강체검자(음성대조조).3조연구대상균사용종합의원억욱초필량표(HAD)진행자평화국인보괄량표(QOL-35)진행생활질량평분.HAD평분≥9분자,재유전업적심리혹정신과의생사용Hamilton초필량표(HAMA)화Hamilton억욱량표(HAMD)진행심리평분.결과 연구조、양성대조조、음성대조조HAD≥9분자분별점32.7%、17.3%화4.0%,연구조여양성대조조、음성대조조비교차이유통계학의의(χ2치분별위27.15화47.16,P＜0.01).3조존재초필혹억욱증상자,초필혹억욱장애적환병솔분별위70.6%、38.5%화0,연구조여양성대조조、음성대조조비교차이유통계학의의(χ2치분별위7.52화9.26,P＜0.01).33.8%적FGID환자생활질량하강,7.8%적환자생활질량명현하강,16.7%적양성대조화4.7%적음성대조생활질량하강.재연구조HAD≥9분자(143례)중,불동QOL-35평분자HAD、HAMA、HAMD평분불동,차이유통계학의의(P＜0.05);QOL-35평분월저,HAD、HAMA、HAMD평분월고.결론 근1/3적FGID환자존재억욱혹초필증상,차FGID환자억욱혹초필증상발생솔현저고우기질성위장질병환자화건강자;FGID환자적생활질량하강,차생활질량월저,환자적초필혹억욱월엄중.
Objective To explore the effects of psychological factors (anxiety and depression) on quality of life of patients with functional gastrointestinal diseases(FGID).Methods Forty-five patients consistent with Roma Ш diagnosis standard on FGID as trial group were enrolled,including 150 for each of functional diarrhea,irritable bowel syndrome and functional constipation; 150 patients with organic gastrointestinal diseases as positive controls and 150 healthy physical examinees as negative controls were also enrolled.The Hospital Anxiety and Depression Scale (HAD) was used for self-assessment,and Chinese Quality of Life Score-35 (QOL-35) was taken to score.For those whose HAD≥9 were again scored by professional psychologist or psychiatrist according to Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD).Results The subjects with HAD≥9 in the trial,positive control and negative control groups accounted respectively for 32.7%,17.3% and 4.0%; difference between the trial group and positive and negative control groups was significant(χ2=27.15,47.16,P＜0.01).The morbidities of anxiety/depression in the 3 groups were respectively 68.7%,38.5% and 0,with a significant difference between the trial group and positive and negative control groups (χ2=7.52,9.26,P＜0.01).The QOL of 33.8% FGID patients got lower,and 7.8% obviously lower; and the QOL of 16.7% subjects in the positive group and 4.7% subjects in the negative control group got a little lower.The differences in score of QOL-35 and in HAD,HAMA and HAMD scores for the patients with HAD≥9 showed significantly different (P＜0.05).The lower the QOL-35 score were,the higher the HAD,HAMA and HAMD scores were.Conclusion Some 1/3 FGID patients have anxiety/depression symptoms,and the prevalence of the FGID patients is remarkably higher than those of the patients with organic gastrointestinal diseases and health persons.The quality of life of FGID patients decreases,and the lower the life quality is,the severer the patients′ anxiety/depression is.