| 合并上消化道症状对功能性便秘患者焦虑、抑郁及生活质量的影响 |
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| 引用本文： | 俞汀,朱锋,林琳,汤玉蓉. 合并上消化道症状对功能性便秘患者焦虑、抑郁及生活质量的影响[J]. 中华全科医学, 2022, 20(10): 1641-1644. DOI: 10.16766/j.cnki.issn.1674-4152.002668 |
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| 作者姓名： | 俞汀 朱锋 林琳 汤玉蓉 |
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| 作者单位： | 南京医科大学第一附属医院消化科，江苏 南京 210029 |
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| 基金项目： | 国家自然科学基金面上项目81870378国家自然科学基金青年基金项目82000508 |
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| 摘 要： | 目的 探讨合并上消化道症状(GI)对功能性便秘(FC)患者焦虑、抑郁及生活质量(HRQoL)的影响。 方法 根据罗马Ⅳ标准纳入2016年10月—2019年10月于南京医科大学第一附属医院胃肠动力中心就诊的156例FC患者，分别采用胃肠道症状评分量表(GSRS)、ZUNG焦虑、抑郁自评量表(SAS/SDS)和简明健康调查问卷(SF-36)评估患者上消化道症状、焦虑、抑郁及健康相关生活质量。 结果 156例FC患者中有95例(60.90%)合并上消化道症状。其中，单纯合并反酸/烧心11例(7.05%)，单纯合并上腹胀23例(14.74%)，单纯合并嗳气11例(7.05%)，同时合并反酸/烧心与上腹胀7例(4.49%)，同时合并嗳气与上腹胀32例(20.51%)，同时合并嗳气与反酸/烧心11例(7.05%)。与无上消化道症状组相比，合并上消化道症状组SAS、SDS评分显著增高(均P < 0.05)，生理功能、生理职能、一般健康、情感职能、精神健康评分显著降低(均P < 0.05)。而在合并上消化道症状的FC患者中，同时合并嗳气与上腹胀组SAS、SDS评分最高，生理职能、社会功能、情感职能评分最低。多元线性回归分析显示，同时合并嗳气与上腹胀及SAS评分高是SF-36总评分的负性预测因子(均P＜0.05)。 结论 反酸/烧心、上腹胀及嗳气是FC患者最常见的上消化道症状，合并上消化道症状加重FC患者焦虑、抑郁，降低健康相关生活质量。
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| 关 键 词： | 功能性便秘 上消化道症状 焦虑 抑郁 健康相关生活质量 |
| 收稿时间： | 2021-12-05 |
Impact of combined upper gastrointestinal symptoms on anxiety,depression and quality of life of patients with functional constipation |
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| Affiliation: | Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China |
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| Abstract: | Objective To explore the effect of combined upper gastrointestinal (GI) symptoms on anxiety, depression and health-related quality of life (HRQoL) in patients with functional constipation (FC). Methods According to the Rome Ⅳ diagnostic criteria, patients with FC who were admitted to the Gastrointestinal Motility Center of the First Affiliated Hospital of Nanjing Medical University from October 2016 to October 2019 were included. Gastrointestinal symptom rating scale, ZUNG anxiety and depression self-rating scale (SAS and SDS) and concise health questionnaire (SF-36) were used in assessing upper GI symptoms, anxiety and depression and HRQoL. Results Among 156 patients with FC, 95 (60.90%) had upper gastrointestinal symptoms: 11(7.05%) only had acid reflux and heartburn, 23(14.74%) only had upper abdominal distension, 11(7.05%) only had belching, 7(4.49%) had acid reflux, heartburn and upper abdominal distension, 32(20.51%) had belching and upper abdominal distension and 11(7.05%) had belching, acid reflux and heartburn. Compared with FC patients without upper GI symptoms, those who had upper GI symptoms show higher scores of SAS and SDS (all P < 0.05), and lower score of role physical, physical functioning, general health, role emotional and mental health (all P < 0.05). Among patients with upper GI symptoms, patients who had both belching and upper abdominal distension show higher scores of SAS and SDS, and lower scores of physical functioning, social functioning and role emotional. Furthermore, combined with both belching and upper abdominal distension and high score of SAS was predictor of poorer SF-36 total score (all P < 0.05). Conclusion Acid reflux and heartburn, upper abdominal distension and belching are the most common upper GI symptoms in patients with FC. The combined upper GI symptoms increases anxiety and depression and reduce the HRQoL in the patients. |
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