反流性食管炎的精神心理因素分析及治疗

目的探讨精神心理因素与反流性食管炎（RE）的关系及抗抑郁治疗的效果。方法对100例RE患者行汉密顿焦虑量表（HAMA）及汉密顿抑郁量表（HAMD）评分,观察其中43例异常者常规治疗对HAMA、HAMD评分影响。76例经常规治疗症状未见改善者随机分为常规组和综合组,综合组在常规治疗基础上联合帕罗西汀,观察治疗后HAMA、HAMD评分及临床症状积分变化。结果 RE患者焦虑、抑郁症发生率高于普通人群;常规治疗后HAMA、HAMD评分下降;综合组联合治疗后HAMA、HAMD评分及临床症状积分显著下降（P=0·040,P=0·006,P=0·027）。结论 RE与精神心理因素有关,抗抑郁治疗能提高临床疗效。

Analysis and treatment of psychiatric and psychological factors of reflux esophagitis

Objective To explore the relationship and effect of antidepressant treatment between psychiatric and psychological factors and refluxesophagitis（RE）.Methods 100 patients with RE were evaluated with Hamilton＇s anxiety scale（HAMA） and Hamilton＇s depression scale（HAMD）.After treatment of protonpump inhibitor（PPI）,the score were observed in 43 patients who were abnormal in HAMA and HAMD.The other76 patients were divided randomly into a conventional group and a integrated group：The conventional group treated with PPI,the integrated group treated with Paroxetine and PPI.Then the changes of the HAMA,HAMD and clinical score were observed.Results The rate of RE with anxiety and depression was higher than the healthy population.The HAMA and HAMD score were lower post-treatment with PPI.In the integrated group,the HAMA,HAMD and clinical scores were decreased（P=0·040,P=0·006,P=0·027）.Conclusion RE is related to psychiatric and psychological factors.Antidepressant treatment may contribute to the improvement of curative effects.