目的 探讨FD患者的躯体化症状以及联合抗躯体化症状治疗对其生活质量的影响.方法 纳入219例FD患者,完成患者健康问卷躯体症状群量表15项(PHQ-15)和Nepean消化不良指数(NDI)评分,分析两者之间的关系.对采用常规PPI和(或)促动力药治疗后4周疗效差及PHQ-15＞4分的131例FD患者,服用兰索拉唑、莫沙必利联合氟哌噻吨美利曲辛(抗躯体化症状治疗)4周,而后观察疗效,分析治疗前后躯体化症状及NDI的变化.采用t检验、卡方检验、Spearman相关分析和线性回归进行统计学分析.结果 219例FD患者的PHQ-15总评分为(5.7±3.4)分,NDI总评分为(42.0±10.4)分,两者呈正相关(r=0.493,P＜0.05).胃痛、头痛、胸痛、头晕、气促、感到疲乏或精力不足、睡眠困难、口干等与NDI总评分呈正相关(r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281;P均＜0.05).胸痛、胃痛、气促、头晕、感到疲乏或精力不足是NDI的影响因素(t=2.340,2.488,5.278,2.167,2.443;P均＜0.05).131例采用联合抗躯体化症状治疗的FD患者中,6例因不良反应而未完成治疗,故最终125例被纳入分析.治疗前和治疗后4周,125例FD患者的PHQ-15总评分分别为(7.3±3.2)分和(2.9±2.2)分,差异有统计学意义(t=12.653,P＜0.01).胃痛、头痛、胸痛、头晕、气促、感到疲乏或精力不足、睡眠困难、口干在患者治疗前后的不同被扰程度(无影响、略有影响和有较大影响)中比较差异均有统计学意义(x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390,16.506;P均＜0.05).治疗前NDI总评分为(44.3±11.7)分,治疗后为(29.2±6.9)分,差异有统计学意义(t=12.503,P＜0.01).结论 FD患者的躯体化症状如胸痛、胃痛、气促、头晕、感到疲乏或精力不足等影响其生活质量.对于常规治疗效果差的FD患者,通过联合抗躯体化症状治疗可能提高其生活质量.
目的 探討FD患者的軀體化癥狀以及聯閤抗軀體化癥狀治療對其生活質量的影響.方法 納入219例FD患者,完成患者健康問捲軀體癥狀群量錶15項(PHQ-15)和Nepean消化不良指數(NDI)評分,分析兩者之間的關繫.對採用常規PPI和(或)促動力藥治療後4週療效差及PHQ-15＞4分的131例FD患者,服用蘭索拉唑、莫沙必利聯閤氟哌噻噸美利麯辛(抗軀體化癥狀治療)4週,而後觀察療效,分析治療前後軀體化癥狀及NDI的變化.採用t檢驗、卡方檢驗、Spearman相關分析和線性迴歸進行統計學分析.結果 219例FD患者的PHQ-15總評分為(5.7±3.4)分,NDI總評分為(42.0±10.4)分,兩者呈正相關(r=0.493,P＜0.05).胃痛、頭痛、胸痛、頭暈、氣促、感到疲乏或精力不足、睡眠睏難、口榦等與NDI總評分呈正相關(r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281;P均＜0.05).胸痛、胃痛、氣促、頭暈、感到疲乏或精力不足是NDI的影響因素(t=2.340,2.488,5.278,2.167,2.443;P均＜0.05).131例採用聯閤抗軀體化癥狀治療的FD患者中,6例因不良反應而未完成治療,故最終125例被納入分析.治療前和治療後4週,125例FD患者的PHQ-15總評分分彆為(7.3±3.2)分和(2.9±2.2)分,差異有統計學意義(t=12.653,P＜0.01).胃痛、頭痛、胸痛、頭暈、氣促、感到疲乏或精力不足、睡眠睏難、口榦在患者治療前後的不同被擾程度(無影響、略有影響和有較大影響)中比較差異均有統計學意義(x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390,16.506;P均＜0.05).治療前NDI總評分為(44.3±11.7)分,治療後為(29.2±6.9)分,差異有統計學意義(t=12.503,P＜0.01).結論 FD患者的軀體化癥狀如胸痛、胃痛、氣促、頭暈、感到疲乏或精力不足等影響其生活質量.對于常規治療效果差的FD患者,通過聯閤抗軀體化癥狀治療可能提高其生活質量.
목적 탐토FD환자적구체화증상이급연합항구체화증상치료대기생활질량적영향.방법 납입219례FD환자,완성환자건강문권구체증상군량표15항(PHQ-15)화Nepean소화불량지수(NDI)평분,분석량자지간적관계.대채용상규PPI화(혹)촉동력약치료후4주료효차급PHQ-15＞4분적131례FD환자,복용란색랍서、막사필리연합불고새둔미리곡신(항구체화증상치료)4주,이후관찰료효,분석치료전후구체화증상급NDI적변화.채용t검험、잡방검험、Spearman상관분석화선성회귀진행통계학분석.결과 219례FD환자적PHQ-15총평분위(5.7±3.4)분,NDI총평분위(42.0±10.4)분,량자정정상관(r=0.493,P＜0.05).위통、두통、흉통、두훈、기촉、감도피핍혹정력불족、수면곤난、구간등여NDI총평분정정상관(r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281;P균＜0.05).흉통、위통、기촉、두훈、감도피핍혹정력불족시NDI적영향인소(t=2.340,2.488,5.278,2.167,2.443;P균＜0.05).131례채용연합항구체화증상치료적FD환자중,6례인불량반응이미완성치료,고최종125례피납입분석.치료전화치료후4주,125례FD환자적PHQ-15총평분분별위(7.3±3.2)분화(2.9±2.2)분,차이유통계학의의(t=12.653,P＜0.01).위통、두통、흉통、두훈、기촉、감도피핍혹정력불족、수면곤난、구간재환자치료전후적불동피우정도(무영향、략유영향화유교대영향)중비교차이균유통계학의의(x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390,16.506;P균＜0.05).치료전NDI총평분위(44.3±11.7)분,치료후위(29.2±6.9)분,차이유통계학의의(t=12.503,P＜0.01).결론 FD환자적구체화증상여흉통、위통、기촉、두훈、감도피핍혹정력불족등영향기생활질량.대우상규치료효과차적FD환자,통과연합항구체화증상치료가능제고기생활질량.
Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.
