摘要
目的探讨慢性胃炎伴幽门螺杆菌(Hp)感染患者情绪障碍的诊断与治疗。方法对280例慢性胃炎伴Hp感染患者采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)进行情绪状态评分,其中93例伴抑郁和(或)焦虑情绪的患者采用随机数字表法分为3组,A组:给予抗抑郁及常规治疗,B组:给予抗抑郁治疗,C组:给予常规治疗,疗程均为8周,抗Hp治疗(12周),治疗前后进行消化道症状及情绪状态评分,并检查胃镜及^(13)C-尿素呼气试验(^(13)C-UBT)。采用SPSS 12.0统计软件包进行统计,治疗前后各量表评分及消化道症状评分比较用t检验,临床疗效比较采用卡方检验。结果慢性胃炎伴Hp感染患者因担心癌变情绪障碍发生率为33.2%,对照组情绪障碍为2.7%,差异有统计学意义(χ~2=80.02,P<0.05)。A组患者治疗后的消化道症状明显改善至消失,与治疗前比较差异有统计学意义[治疗前(25.3±4.1)分,治疗后(11.4±1.6)分,t=14.1,P<0.05],B组患者部分改善[治疗前(25.4±3.9)分,治疗后(15.3±3.1)分,t=5.8,P<0.05],C组患者无明显改善[治疗前(25.2±4.4)分,治疗后(19.8±3.7)分,t=1.9,P>0.05]。结论慢性胃炎伴Hp感染患者抑郁焦虑情绪发生率较高,常规抗Hp不能改变与情绪障碍相关的症状,总体疗效差,抗抑郁治疗部分有效,而抗抑郁加常规治疗能显著改善患者的胃肠道症状和抑郁焦虑情绪障碍。
Objective To investigate the diagnosis of mood disorder in patients with chronic gastritis infected with helieobaeter pylon （Hp） ,and explore the effects of different therapies.Methods The psychological status of chronic gastritis infected with Hp （ two hundred and eighty cases） was analyzed with Hamilton Depression/Anxiety （HAMD/HAMA） Scales.Additionally, the patients with depression or anxiety （ninty-three cases） were randomly divided into three groups：group A received routine and antidepressant treatments ,group B received antidepressant treatment and group C received routine treatment. Efficacy was assessed by patients＇ perception of overall digestive symptoms and HAMD/HAMA Scales, and the infection of Hp was detected by 13C-urea Breath test （13C-UBT）. Results The prevalence rate of depression or anxiety in chronic gastritis with Hp by the worry about cancer was 33.2% （93/280）.The positive rate of 13C- UBT was 12.0% （9/30） in group A, 89.0% （25/28） in group B, 16.7% （5/30） in group C after 8-week treatment.The seventy of patients＇ perception of overall digestive symptoms was significantly improved in group A after 8-week treatment（ 25.3±4.1,11.4± 1.6, t = 14.1, P 〈0.05） ,partly improved in group B （25.4 ±3.9,15.3±3.1, t = 5.8, P 〈0.05） ,and not improved at all in group C（25.2±4.4, 19.8±3.7, t = 1.9, P 〉 0.05） .There was significant difference of overall digestive symptoms in group A or B compared with that in group C （ t =7.3,5.2; P 〈0.05） ,but the difference was not significant between group A and group B（ t = 2.1, P 〉 0. 05 ）. The total clinical efficiency of mood disorder were 85.0%, 81.0% and 38.0%. Conclusions The prevalence rate of depression and anxiety is higher in chronic gastritis infected with Hp. Routine treatment is ineffective, and antidepressant treatment is partly effective. The combination of both treatments can effectively improve their somatic and psychiatric symptoms.
出处
《中华诊断学电子杂志》
2015年第3期52-55,共4页
Chinese Journal of Diagnostics(Electronic Edition)
基金
国家自然科学基金青年科学基金(81001078)
关键词
慢性胃炎
幽门螺杆菌
情绪障碍
抗抑郁治疗
Chronic gastritis
Helicobacter pylori
Mood disorder
Antidepressant treatment
