基于脑-肠轴学说探讨老年功能性消化不良患者睡眠障碍对焦虑抑郁和下消化道症状影响

背景功能性消化不良(functional dyspepsia,FD)是老年患者常见疾病之一,病情容易反复,严重影响患者身心健康.肠-脑互动异常是FD发病主要病因,大多伴有不同程度的睡眠障碍和焦虑、抑郁等负面心理.目前,对于老年FD患者与睡眠障碍和焦虑抑郁、下消化道症状的研究报道较少.目的基于脑-肠轴学说探讨观察老年FD患者睡眠障碍对焦虑抑郁和下消化道症状影响分析.方法选择2017-02/2019-09在我院就诊的236例老年FD患者为研究对象,课题负责人发放量表,对符合罗马Ⅳ标准的老年FD患者进行调查,评估其下消化道症状严重程度,睡眠质量和焦虑和抑郁评分变化情况.结果214例老年FD患者中存在睡眠障碍者103例(48.13%),存在焦虑、抑郁者182例(85.05%).有睡眠障碍老年FD患者的下腹痛发生率为35.92%,下腹不适(非疼痛)发生率为33.98%、羊粪样或硬便发生率为21.36%、用劲排便发生率为32.04%、排便不尽感发生率为43.69%和便急感的发生率为27.18%,均高于无睡眠障碍老年FD患者,差异比较均有统计学意义(P<0.05).有睡眠障碍的老年FD睡眠障碍患者焦虑自评量表评分为65.34分±7.29分,抑郁自评量表评分为66.17分±8.26分,均高于无睡眠障碍的老年FD患者(P<0.05).结论老年FD患者常同时存在睡眠障碍与焦虑、抑郁,睡眠障碍与老年FD患者的下消化道症状关系密切.

Evaluation of effects of sleep disorders on anxiety,depression,and lower gastrointestinal symptoms in elderly patients with functional dyspepsia based on brainintestinal axis theory

BACKGROUND Functional dyspepsia(FD)is a common disease in elderly patients,which is prone to relapse and seriously affects the physical and mental health of patients.Brainintestinal interaction disorder is the main cause of FD,and most of FD patients are accompanied by different degrees of sleep disorders,anxiety,depression,and other negative psychology.At present,there are few studies on sleep disorders,anxiety,depression,and lower gastrointestinal symptoms in elderly FD patients.AIM To investigate the effects of sleep disorders on anxiety,depression,and lower gastrointestinal symptoms in elderly patients with FD based on the brain-intestinal axis theory.METHODS A total of 236 elderly patients with FD diagnosed based on the RomanⅣcriteria at our hospital from February 2017 to September 2019 were included in this study.Different scales were used to evaluate digestive tract symptom severity,sleep quality,and anxiety and depression.RESULTS Among 214 elderly FD patients,103(48.13%)had sleep disorders and 182(85.05%)had anxiety and depression.In elderly FD patients with sleep disorders,the incidences of lower abdominal pain,abdominal discomfort,sheep dung-like or hard feces,difficulty in defecation,feeling of incomplete defecation,and urgent need for defecation were 35.92%,33.98%,21.36%,32.04%,43.69%,and 27.18%,respectively,all of which were significantly higher those of elderly FD patients with no sleep disorder(P<0.05).The self-rating anxiety scale score of elderly FD patients with sleep disorders was 65.34±7.29 and the self-rating depression scale score was 66.17±8.26,both of which were significantly higher than those of elderly FD patients without sleep disorders(P<0.05).CONCLUSION Sleep disorders,anxiety,and depression are often present in elderly FD patients,and sleep disorders are closely related to lower gastrointestinal symptoms in elderly FD patients.