功能性消化不良重叠症状与精神心理因素关系的初步研究

目的 探索功能性消化不良(FD)重叠症状与精神心理因素间的关系,以加深对症状重叠现象的认识和指导诊治.方法 将103例符合罗马Ⅲ标准的FD患者分为有重叠症状和无重叠症状组,比较两组患者在情绪状态(自评量表)、睡眠状况(自评量表)、焦虑和抑郁状态(Zung焦虑和抑郁自评量表)和生活质量(SF-36问卷中文版)方面的差异.结果 ① 103例FD患者中·39例(37.9%)无重叠症状,64例(62.1%)有重叠症状.②有重叠症状组的情绪状态中表现为"欠佳"和"很差"者分别为39.1%和20.2%,比无重叠症状组高(15.4%和12.8%,P=0.018).③有重叠症状组的睡眠状况表现为"欠佳"和"很差"者分别为45.3%和11.0%,比无重叠症状组高(19.1%和7.7%,P=0.018).④有重叠症状组合并焦虑和抑郁状态的比例为49%和68%,比无重叠症状组高(19%和44%,P值分别=0.004和0.022).⑤有重叠症状组心理复合分为32.8,精神健康为47.9,活力为47.1,比无重叠症状组低(37.0、57.8和57.0,P值分别=0.045、0.015和0.026).结论 异常精神心理因素与FD患者症状重叠现象间存在联系,提示异常精神心理因素可能是重叠症状产生的机制之一.

Relationship between overlapping symptoms and psycho-mental factors in patients with functional dyspepsia

Objective To study the relationship between overlapping symptoms (OS) and psycho- mental factors in patients with functional dyspepsia (FD) in order to understand the possible mechanisms of OS.Methods One hundred and three FD patients diagnosed by Rome Ⅲ criteria were divided into with or without OS groups by Rome Modular Questionnaire.The emotional status,sleep status,anxiety and depression status were evaluated by Zung Anxiety and Depression Scale and quality of life was eveluated by SF-36 questionnaire.The results were compared between the two groups.Results The proportion of the patients with and without OS accounted for 62.5% and 37.5%,respectively.The patients with OS had a worse emotional status ("bad%" and "very bad%" being 39.1% and 20.2% vs.15.4% and 12.8%,P=0.018) and a worse sleep status (45.3% and 11.0% vs.19.1% and 7.7%,p=0.018)than those without OS.The proportion of the patients with anxiety (49 % ) and depression (68 % ) status in OS group was significantly higher than that in without OS group (19% and 44%,respectively,P＜0.05). The quality of life of the patients with OS was worse in the dimensions of psychological health (47.9), vitality (47.1) and mental component score (32.8)than those in without OS group (57.8,57.0,37.0, respectively,P＜0.05).Conclusions The psycho-mental factors are associated with overlapping symptoms in patients with FD,which suggests that abnormal psycho-mental factors may be involved in the mechanisms underlying overlapping gastrointestinal symptoms in FD.