52例消化性溃疡患者的社会心理状况探讨

正消化性溃疡是指发生于胃和十二指肠的慢性溃疡,心理矛盾和情绪应激在消化性溃疡中的致病作用受到越来越多人们的关注。本文探讨消化性溃疡患者的社会心理状态,报告如下。1对象与方法1.1研究对象选取我院2013-01—2014-12消化内科收治的52例患者,男32例,女20例,平均年龄(45.26±5.67)岁;其中胃溃疡28例,十二指肠溃疡24例。发放问卷全部收回,有效回收率100%。     

抗抑郁药在消化性溃疡中的应用

进入21世纪以来,随着生活节奏的加快和受不良因素的影响,全球消化性溃疡的发生率和致死率逐年上升,严重影响人们的健康和生活质量。传统西医防治消化性溃疡主要采取抑酸制剂、黏膜保护剂及抗生素联合应用的方案,不能解决其复发的问题。消化性溃疡是一种常见的心身疾病,精神心理因素对该病的发生有重要影响,多种抗抑郁药已被用于消化性溃疡的治疗。本文总结近年来常用抗抑郁药治疗消化性溃疡的临床研究,为消化性溃疡的治疗提供新的思路。     

消化性溃疡患者危险因素的初步对照研究

目的探讨影响消化性溃疡患者的危险因素.方法对31例消化性溃疡和34例慢性胃炎患者予症状自评量表(SCL-90)和生活事件量表(LES)评定,同时测血清胃泌素及血清一氧化氮进行对照分析.结果(1)消化性溃疡患者SCL-90的躯体化、人际关系敏感、焦虑、抑郁、强迫分值较慢性胃炎组显著增高;(2)LES的工作问题分消化性溃疡组显著性高于对照组;(3)试验组血清胃泌素显著高于对照组,而血清一氧化氮则显著低于对照组.结论对消化性溃疡患者应采取生物-心理-社会整体医学模式进行综合治疗.     

洛赛克治疗消化性溃疡病临床观察

１９９８年１０月至２０００年１１月，应用洛赛克治疗活动性胃、十二指肠球部溃疡３７例，取得显著疗效。现报道如下：1 临床资料1．１ 病例选择 本组经纤维胃镜确诊为活动性消化性溃疡３７例，溃疡直径为２０～３０ｍｍ，溃疡数１～２个，男２６例，女１１例，年龄１５～６９岁，平均４０．９岁。病程最短１年，最长４０年，其中十二指肠溃疡２１例，胃溃疡１０例，复合性溃疡６例；吸烟者２２例，有饮酒习惯２１例，同时伴有上消化道出血６例，幽门不全梗阻２例，所有病例都用过不同的抗溃疡药物。1．２ 治疗方法 首先停用其他所有的抗溃…     

消化性溃疡患者精神心理状态和心理防御机制的研究

目的研究消化性溃疡患者是否存在精神心理状态及心理防御机制障碍,及其与自身疾病的关系。方法以近2年来我院收治的80例消化性溃疡患者为观察组,并将同期行体检的健康人群80例作为对照组,使用症状自评量表(SCL-90)、心理防御方式问卷(DSQ)和社会支持评定量表(SSRS)对患者的精神心理状态和心理防御机制及社会支持状况,并进行分析总结。结果观察组在心理防御方式、人格、社会支持等心理因素上的缺陷相比对照组更为突出,差异有统计学意义(P0.05),习惯于采用不成熟的心理防御方式、过度掩饰、精神病性、社会支持利用和敌对造成消化性溃疡发病的危险因素(P0.01)。结论消化性溃疡患者的确存在精神心理问题和不恰当的心理防御机制,社会支持方面也存在问题,且上述问题可能是导致消化性溃疡产生的危险因素。     

100例消化性溃疡心理因素研究

消化性溃疡是一种常见的心身疾病，为了探讨其心理因素及治疗效果，对100例消化性溃疡尔姆生活事件心理应激评定表评定，并对62例有明显精神因导进行焦虑抑郁量表评定，结果显示62侧有精神因素，且有焦虑抑郁、强迫、睡眠障碍，躯体化症状，合并抗抑郁药及心理治疗疗效好且疗程短。     

西酞普兰合并西咪替丁治疗消化性溃疡对照分析

目的 探讨西酞普兰合并西咪替丁对消化性溃疡患者的治疗作用.方法 将125例确诊的消化性溃疡患者按分层随机法分为研究组(65例)和对照组(60例),研究组应用西酞普兰合并西咪替丁治疗,对照组单用西咪替丁,观察两组治疗前后溃疡灶的变化情况以及症状自评量表(SCL-90)对比.结果 研究组溃疡愈合51例(78.46%),好转14例(21.54),无效0例;对照组溃疡愈合35例(58.33%),好转24例(40.00%),无效1例(1.67%);两组具有显著性差异(x2=6.42,P＜0.05).治疗前SCL-90的总分、总均分、阳性项目数两组均无显著性差异(P＞0.05),但均高于常模;治疗后,研究组的总分、总均分、阳性项目数和躯体化、强迫、抑郁、焦虑4个因子分显著低于对照组(P＜0.05),与疗前评分相比有显著降低(P＜0.05).结论 消化性溃疡患者多存在心理问题,西酞普兰既能提高消化性溃疡的治疗效果,又能促进患者的心理健康,提高患者的生活质量.     

慢性消化性溃疡伴抑郁障碍100例诊治体会

急性应激可引起应激性溃疡已是共识,临床观察发现长期精神紧张,过劳确实易使消化性溃疡发作或加重,因此情绪应激可能为重要诱因,可能通过神经内分泌途径影响胃、十二指肠分泌、运动和黏膜血流调节[1].我们对慢性消化性溃疡和抑郁症进行评价和治疗为心理治疗消化性溃疡提供了依据.     

消化性溃疡患者社会心理因素研究

目的研究消化性溃疡患者社会心理因素的特点及影响因素。方法运用生活事件量表、A型行为量表、多伦多述情障碍量表、抑郁自评量表、焦虑自评量表、应付方式问卷、社会支持问卷，测定46例消化性溃疡患者及49例正常对照组病前遭遇的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素。结果病例组本次患病前所经历的生活事件频数及紧张值，A型行为评分，消极应付方式评分，抑郁及焦虑分值均显著高于对照组。积极应付评分，社会支持总分减低。发现家族史、生活事件紧张总值、A型行为和抑郁为消化性溃疡的危险因素，而积极应付方式和社会支持为疾病的保护因子。结论消化性溃疡患者具有特殊的心翠社会特征和心身健康状况，应采取积极的社会心理干预措施。     

实时荧光PCR法定量小腿慢性静脉性溃疡表面的细菌分布★

背景：小腿慢性静脉性溃疡表面的细菌在溃疡的愈合过程中起重要作用，但细菌的种类、密度与溃疡愈合的关系仍然存在争议。 目的：探讨小腿慢性静脉性溃疡中的常见菌群种属和细菌量与溃疡愈合的关系。 方法：纳入2009-05/2010-09重庆医科大学第一附属医院血管外科诊断为小腿慢性静脉性溃疡患者39例，共42条患肢。所有患者均进行标准的加压疗法治疗，经过6个月的随访以确定溃疡的愈合率，42条患肢中，28条患肢在6个月内完全愈合，为愈合组，14条患肢未完全愈合，为未愈合组。获取治疗前所有溃疡的组织样本，提取样本中的细菌基因组DNA，合成细菌的通用引物及下肢慢性静脉性溃疡中常见细菌种属的特异性引物，运用常规PCR及荧光定量PCR方法比较愈合组与未愈合组溃疡表面的细菌差异。 结果与结论：愈合组和未愈合组标本中都可检测到细菌，最常见的细菌为金黄色葡萄球菌和铜绿假单胞杆菌。荧光定量PCR结果显示未愈合组标本中的细菌总量较愈合组明显增多(P < 0.05)，两组中金黄色葡萄球菌、铜绿假单胞杆菌的含量无明显差异(P > 0.05)。实验结果中未见任何一种溃疡的常见细菌种属与溃疡的愈合具有直接关系，而溃疡中的细菌总量与溃疡的愈合有较大的关联。结果表明溃疡表面细菌总量的增加引起的皮肤慢性感染可能是导致小腿慢性静脉性溃疡长期不愈合的重要原因。     

消化性溃疡和神经症心理防御机制的对照研究

目的　探讨消化性溃疡和神经症心理防御机制的差别。方法　采用心理防御方式问卷对 4 7例消化性溃疡、6 7例神经症患者进行测试 ,并与 72例健康人作对照。结果　消化性溃疡组与正常组相比较多使用潜意显现、躯体化、理想化 ,较少使用回避 ;神经症组与正常对照组相比较多使用潜意显现、躯体化、理想化、隔离、交往倾向 ,较少使用被动攻击、抱怨、制止、回避、幽默 ;消化性溃疡组与神经症组相比较多使用幽默、伴无能之全能 ,较少使用投射、退缩、交往倾向。结论　消化性溃疡及神经症具有不同的防御方式 ,在临床工作中必须予以针对性处理     

Peptic ulcer complaints in lithium-treated and non-lithium-treated manic-depressive patients

ABSTRACT - A possible protective effect of lithium against the occurrence of peptic ulcer complaints in manic-depressive patients, treated with lithium, was investigated. 167 manic-depressive patients, 91 in lithium treatment, 76 not in lithium treatment, were questioned about clinical symptoms of peptic ulcer. Thirteen of the lithium-treated and 23 of the non-lithium-treated patients reported symptoms of peptic ulcer. The difference was statistically significant. The hypothesis that lithium treatment reduces the frequency of symptoms of peptic ulcer in manic-depressive patients was thus confirmed.     

Psychologic correlates in peptic ulcer]

Psychological correlates of peptic ulcer were assessed in a group of volunteer patients whose ulcers were identified by endoscopy. Logistic regression analysis and "t" test indicates that the peptic ulcer patients studied had higher "neuroticism" scores on EPQ, more life events experienced in the year previous to the investigation (on the revised Holmes' Social Readjustment Rating Scale), more severe symptoms on SCL-90, and lower social support scores on the Social Support Rating Scale than matched controls. The most frequently reported SCL-90 symptoms were anxiety, depression, somatization and obsession. The relationship between the occurrence of peptic ulcer and the characteristics of personality, life events, social support and psychological health level is discussed.     

The role of psychosocial factors in peptic ulcer disease: beyond Helicobacter pylori and NSAIDs

A variety of organic etiologies are associated with peptic ulcer disease, and the most relevant of these are infection with Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs. Between 5% and 20% of patients with gastric or duodenal ulcer, however, lack an identifiable organic etiology. In these patients particularly and in all ulcer patients in general, psychosocial factors may play a significant role. At present, there is no definitive study proving a causal relationship between psychological stress and the development of ulcer disease. Studies to date suffer from significant methodological limitations and have not effectively addressed the poor correlation between ulcer craters and ulcer symptoms. A conservative application of available data would suggest that psychosocial factors play a significant role in symptom perception and reporting in patients with dyspeptic symptoms and may play a role in ulcer formation.     

Primary peptic ulcer in childhood : PSYCHOSOCIAL,PSYCHOLOGICAL AND PSYCHIATRIC ASPECTS

Twenty-five children with radiologically confirmed primary peptic ulcers were investigated. All patients suffered from duodenal ulcer and there was an unexpected female preponderance. The frequency of introverted personalities was greater in the patients than in the controls. Five patients suffered from psychiatric disorders, three had histories of suicidal attempts and three reported homosexual experiences. Six patients had nicknames. Eight patients had been operated on for appendicitis. The above parameters were negative in all control cases. The patients had lower mean IQ, worse adaptation to school, more anxious and overprotective parents, higher frequency of faddiness in food and lower frequency of nail-biting than the controls. The onset of symptoms was preceded by psychotraumatic events in eight cases. The findings suggest that the manifestation of the genetic background of duodenal ulcer is strongly influenced by environmental factors and factors associated with the personality of the patients.     

Type A behaviour and other psychological factors in peptic ulcer disease

A variety of personality traits and psychological symptom states have been reported to be associated with peptic ulcer disease. In the present study, male patients with confirmed duodenal or gastric ulcer(s) are compared with patient and non-patient control groups in terms of Type A behaviour, the Eysenck personality dimensions, hostility, state and trait anxiety, and depression. By comparison with cardiac patients, the peptic ulcer groups obtained lower Type A scores but were similar on the other variables. By comparison with age and sex matched community controls. GU patients obtained higher trait anxiety and psychoticism scores while the DU group had higher state anxiety levels. The implications of these findings in terms of the role of psychological factors in the aetiology of peptic ulcer disease are discussed.     

Hypothalamic digoxin, hemispheric chemical dominance, and peptic ulcer disease

The isoprenoid pathway produces three key metabolites--endogenous digoxin-like factor (EDLF) (membrane sodium-potassium ATPase inhibitor and regulator of neurotransmitter transport), ubiquinone (free radical scavenger), and dolichol (regulator of glycoconjugate metabolism). The pathway was assessed in peptic ulcer and acid peptic disease and its relation to hemispheric dominance studied. The activity of HMG CoA reductase, serum levels of EDLF, magnesium, tryptophan catabolites, and tyrosine catabolites were measured in acid peptic disease, right hemispheric dominant, left hemispheric dominant, and bihemispheric dominant individuals. All the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listening test. The pathway was upregulated with increased EDLF synthesis in peptic ulcer disease (PUD). There was increase in tryptophan catabolites and reduction in tyrosine catabolites in these patients. The ubiquinone levels were low and free radical production increased. Dolichol and glycoconjugate levels were increased and lysosomal stability reduced in patients with acid peptic disease (APD). There was increase in cholesterol:phospholipid ratio with decreased glyco conjugate levels in membranes of patients with PUD. Acid peptic disease represents an elevated EDLF state which can modulate gastric acid secretion and the structure of the gastric mucous barrier. It can also lead to persistence of Helicobacter pylori infection. The biochemical pattern obtained in peptic ulcer disease is similar to those obtained in left-handed/right hemispheric chemically dominant individuals. But all the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listen ing test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Peptic ulcer disease occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function.     

The association of peptic ulcer and schizophrenia: A population-based study

BackgroundThe association of schizophrenia with peptic ulcer is not conclusive. In the last 30 years, there has been little evaluation of peptic ulcer among schizophrenia patients.MethodsTo explore the relation of peptic ulcer and schizophrenia during this new phase, we used the data from Taiwan insurance claims, identified 1496 schizophrenia patients (ICD-9-CM: 295) and selected 5984 non-schizophrenia controls that were frequency-matched by sex, age, and index year with schizophrenia patients during the years 1998–2001. All subjects were free of peptic ulcer at baseline. We measured incidences of peptic ulcer (ICD-9-CM: 531–534) until the end of 2009.ResultsThe incidence of peptic ulcer was 1.27 times higher in schizophrenia patients than in the control group (12.1vs. 9.52 per 1000 person-years). Patients are at higher risk taking anti-depression, anxiolytic and hypnotics or non-steroidal anti-inflammatory drugs. After controlling the confounding factors, schizophrenia patients had no significant increase incidence of peptic ulcer.ConclusionSchizophrenia patients have a slightly higher risk of peptic ulcer compared to the general population. This might be due to a higher rate of taking anti-depression, anxiolytic and hypnotics or non-steroidal anti-inflammatory drugs and alcoholism among this group.     

The Impacts of Peptic Ulcer on Functional Outcomes of Ischemic Stroke

Background and Purpose: Studies have shown that peptic ulcer increased the risk of ischemic stroke and stroke recurrence. This study aimed to evaluate the impacts of peptic ulcer on functional outcomes of ischemic stroke. Methods: Patients with first-ever ischemic stroke were grouped as with and without history of peptic ulcer. Functional outcomes were evaluated with modified Rankin scale at 90 days after the index stroke. Favorable functional outcomes were defined as with a modified Rankin scale score of 0-2. Logistic regression was used to identify predictors for favorable functional outcomes at 90 days. Results: Among the 2577 enrolled patients with ischemic stroke, 129 (5.0%) had a history of peptic ulcer. The proportion of favorable outcome was higher in patients without peptic ulcer than those with (59.3% versus 42.6%, P < .001). Multivariate logistic analysis detected that history of peptic ulcer (odds ratio [OR] = 2.89, 95% confidence interval [CI], 1.03-8.10, P?=?.043), National Institute of Health Stroke Scale score (OR?=?2.11, 95% CI, 1.79-2.48, P < .001), and large-artery atherosclerosis stroke subtype (OR?=?4.08, 95% CI, 1.11-15.03, P?=?.035) decreased the likelihood of favorable outcomes. Conclusions: Ischemic stroke patients with peptic ulcer may have an increased risk of less favorable neurological outcome at 90 days after the index stroke.