弥漫性食管痉挛患者食管动力与精神心理因素相关性研究

目的：探讨弥漫性食管痉挛（diffuse esophageal spasm,DES）与精神心理因素的关系。方法：使用高分辨多道灌注测压系统（PC polrraf HR瑞典产）,分别对20例对照组、两组各19例弥漫性食管痉挛患者钙拮抗剂联用和非联用抗焦虑药物的服药前后不同时段进行食管动力测定。结果：服药前两组DES食管下段蠕动波幅,食管收缩时间,食管体部运动异常检出率三项指标均高于对照组,服药后30 d两组DES患者与用药前比较,三项指标测定均有显著性差异（P〈0.05）。用药15 d联用抗焦虑药物组的三项指标改善明显优于不联用抗焦虑药物组（P〈0.05）。服药后DES组食管下段蠕动波幅、食管收缩时间和食管体部运动异常检出率与对照组比差异无显著性（P〉0.05）。结论：食管运动功能紊乱、中下段高幅蠕动、收缩时间延长在DES发病中起重要作用,精神和心理因素是重要致病因素。治疗中不可缺少联用抗焦虑药物。

Relative Study of Esophagus Kinetic and Psychological Factor of Patients with Diffuse Esophageal Spasm

Objective:To explore the relationship between diffuse esophageal spasm(DES) and psychological factors.Method:The esophagus kinetic in different time was determinde by using the PC-POLYGRAF HR manometry examination system(PC-POLYGRAF HR,manufactured by Sweden)in 58 patients with diffuse esophageal spasm.Of these patients,20 cases belonged to control group,19 cases were treated with calcium antagonist and anti-anxiety drugs and other 19 cases were only treated with calcium antagonist.Results:Before taking the medicine,the positive rate of esophagus inferior segment peristalsis amplitude,esophagus peristalsis duration and esophagus body department motile abnormality in the two groups was obviously higher than that in control group.After taking the medicine for 30 days,the three parameters were existed significant differences in the two DES group(P<0.05).After taking the medicine for 15 days,the patients treaed with calcium antagonist and anti-anxiey drugs were obviously better than that the patients treated only with calcium antagonist(P<0.05).After taking the medicine,the positive rate of the three parameters in DES group was not significant when compared with control group(P>0.05).Conclusion:Esophagus motile function disorder,inferior segment peristalsis amplitude and peristalsis duration playe an important role on the DES episode.Psychological factor is important inducing factor.Antianxiety drugs will be used in the treatment.