CAJ | 학술논문

目的：探讨慢性胃炎伴幽门螺杆菌（ Hp）感染患者情绪障碍的诊断与治疗。方法对280例慢性胃炎伴Hp感染患者采用汉密尔顿抑郁量表（ HAMD）及汉密尔顿焦虑量表（ HAMA）进行情绪状态评分，其中93例伴抑郁和（或）焦虑情绪的患者采用随机数字表法分为3组，A组：给予抗抑郁及常规治疗，B组：给予抗抑郁治疗，C组：给予常规治疗，疗程均为8周，抗Hp治疗（12周），治疗前后进行消化道症状及情绪状态评分，并检查胃镜及13C?尿素呼气试验（13C?UBT）。采用SPSS 12．0统计软件包进行统计，治疗前后各量表评分及消化道症状评分比较用t检验，临床疗效比较采用卡方检验。结果慢性胃炎伴 Hp感染患者因担心癌变情绪障碍发生率为33．2％，对照组情绪障碍为2．7％，差异有统计学意义（χ2＝80．02， P＜0．05）。 A组患者治疗后的消化道症状明显改善至消失，与治疗前比较差异有统计学意义[治疗前（25．3±4．1）分，治疗后（11．4±1．6）分， t ＝14．1， P ＜0．05]，B组患者部分改善[治疗前（25．4±3．9）分，治疗后（15．3±3．1）分， t ＝5．8， P＜0．05]，C组患者无明显改善[治疗前（25．2±4．4）分，治疗后（19．8±3．7）分， t ＝1．9， P＞0．05]。结论慢性胃炎伴Hp感染患者抑郁焦虑情绪发生率较高，常规抗Hp不能改变与情绪障碍相关的症状，总体疗效差，抗抑郁治疗部分有效，而抗抑郁加常规治疗能显著改善患者的胃肠道症状和抑郁焦虑情绪障碍。
목적：탐토만성위염반유문라간균（ Hp）감염환자정서장애적진단여치료。방법대280례만성위염반Hp감염환자채용한밀이돈억욱량표（ HAMD）급한밀이돈초필량표（ HAMA）진행정서상태평분，기중93례반억욱화（혹）초필정서적환자채용수궤수자표법분위3조，A조：급여항억욱급상규치료，B조：급여항억욱치료，C조：급여상규치료，료정균위8주，항Hp치료（12주），치료전후진행소화도증상급정서상태평분，병검사위경급13C?뇨소호기시험（13C?UBT）。채용SPSS 12．0통계연건포진행통계，치료전후각량표평분급소화도증상평분비교용t검험，림상료효비교채용잡방검험。결과만성위염반 Hp감염환자인담심암변정서장애발생솔위33．2％，대조조정서장애위2．7％，차이유통계학의의（χ2＝80．02， P＜0．05）。 A조환자치료후적소화도증상명현개선지소실，여치료전비교차이유통계학의의[치료전（25．3±4．1）분，치료후（11．4±1．6）분， t ＝14．1， P ＜0．05]，B조환자부분개선[치료전（25．4±3．9）분，치료후（15．3±3．1）분， t ＝5．8， P＜0．05]，C조환자무명현개선[치료전（25．2±4．4）분，치료후（19．8±3．7）분， t ＝1．9， P＞0．05]。결론만성위염반Hp감염환자억욱초필정서발생솔교고，상규항Hp불능개변여정서장애상관적증상，총체료효차，항억욱치료부분유효，이항억욱가상규치료능현저개선환자적위장도증상화억욱초필정서장애。
Objective To investigate the diagnosis of mood disorder in patients with chronic gastritis infected with helicobacter pylori (Hp),and explore the effects of different therapies.Methods The psychological status of chronic gastritis infected with Hp ( two hundred and eighty cases) was analyzed with Hamilton Depression/Anxiety (HAMD /HAMA) Scales.Additionally,the patients with depression or anxiety (ninty?three cases) were randomly divided into three groups:group A received routine and antidepressant treatments,group B received antidepressant treatment and group C received routine treatment. Efficacy was assessed by patients’ perception of overall digestive symptoms and HAMD/HAMA Scales,and the infection of Hp was detected by 13 C?urea Breath test ( 13 C?UBT) . Results The prevalence rate of depression or anxiety in chronic gastritis with Hp by the worry about cancer was 33.2% (93/280).The positive rate of 13C?UBT was 12.0% (9/30)in group A,89.0% (25/28)in group B,16.7% (5/30) in group C after 8?week treatment.The severity of patients’ perception of overall digestive symptoms was significantly improved in group A after 8?week treatment(25.3±4.1,11.4±1.6, t =14.1, P<0.05),partly improved in group B (25.4 ±3.9,15.3±3.1, t =5.8, P<0.05),and not improved at all in group C(25.2±4.4,19.8±3.7, t =1.9, P>0.05).There was significant difference of overall digestive symptoms in group A or B compared with that in group C ( t =7.3,5.2;P<0.05) ,but the difference was not significant between group A and group B( t =2.1, P > 0. 05 ) . The total clinical efficiency of mood disorder were 85. 0%, 81. 0% and 38.0%. Conclusions The prevalence rate of depression and anxiety is higher in chronic gastritis infected with Hp. Routine treatment is ineffective, and antidepressant treatment is partly effective. The combination of both treatments can effectively improve their somatic and psychiatric symptoms.