200例慢性糜烂性胃炎患者情绪障碍及其治疗

目的 调查慢性糜烂性胃炎患者的情绪障碍,并观察不同方法对其治疗的疗效,为临床抗抑郁治疗慢性胃炎提供依据.方法 对200例慢性糜烂性胃炎患者予Zung自评抑郁量表(SDS)、自评焦虑量表(SAS)评分;对其中伴有抑郁或焦虑情绪的患者再予症状自评量表(SCL-90)及消化道症状评分,并分成三组进行治疗,A组患者采用常规治疗 抗抑郁治疗,B组患者采用抗抑郁治疗,C组患者采用常规治疗,疗程均为8周;治疗后再进行各量表评分.结果 (1)慢性糜烂性胃炎患者抑郁、焦虑情绪的发生率为32.5%(65/200),其中伴抑郁者占14%(28/200),伴焦虑者占24.5%(49/200),抑郁焦虑兼有者占6%(12/200);SCL-90评分除精神病理、强迫外其它各项与对照比较均有显著性差异(P《0.05～0.001);(2)A组患者治疗后的消化道症状、情绪障碍(以SDS、SAS标准分之和除以2为情绪障碍评分)、SCL-90评分均显著改善至消失(P《0.001),B组患者部分改善(P《0.05),c组患者无改善(P》0.05);A组与B组比较差异有显著性(P《0.001),B组与c组比较差异无显著性(P》0.05).结论 慢性糜烂性胃炎患者抑郁、焦虑情绪的发生率较高;此类患者常规治疗疗效差,抗抑郁治疗只能部分有效,而两者联合治疗能明显改善患者的消化道症状和精神症状.

Investigating of mood disorder and treatment in the patient with chronic erosional gastritis

Objective To provide evidences of antidepressant treatment for chronic gastritis by investigating the mood disorder in chronic erosional gastritis and exploring the effects of different therapies.Methods The psychological status of 200 chronic erosional gastritis were analyzed by using Zung's self-raring depression scale(SDS) and Zung's self-rating anxiety scale(SAS);Additionally,the patients with depression or anxiety were assessed by SCL-90 scales and digestive symptoms.They were divided into 3 groups:group A received routine and antidepressant treatments,group B received antidepressant treatment and group C received routine treatments.They were reassessed by the scales above after a 8-week treatment.Results(1)The prevalence rate of depression or anxiety in chronic erosional gastritis was 32.5%(65/200),among which the prevalence rate of depression and the anxiety was 14%(28/200) and 24.5%(49/200) respectively,and the prevalence of both were 6%(12/200).Besides psychiatric pathology and compulsion,the difference was significant in SCL-90 scale scores between the patients and normal subjects(P<0.05~0.001).(2)Improvement of digestive symptoms,mood disorder(the total standard scores of SDS and SAS divided by 2) and SCL-90 scale scores after treatment:significantly improved in group A(P<0.001),partly improved in group B(P<0.05),and not improved at all in group C(P>0.05).There was significant difference between group A and B(P<0.001),but the difference was not significant between B and C(P>0.05).Conclusion The prevalence rate of depression and anxiety is higher in the chronic erosional gastritis patients.Routine treatment is ineffective,antidepressant treatment is partly effective,while combining the two treatments can effectively improve their somatic and psychiatric symptoms.