摘要
老年人群中的胃食管反流病(GERD)发病率逐年上升,已成为老年人群常见的消化系统疾病之一。老年人食管-胃连接处抗反流机制减弱、食管运动异常以及内脏高敏感是导致GERD发病的核心机制,这些机制均与精神心理及“肠脑”互动异常有关。早期识别和评估老年GERD患者是否伴有精神心理发病因素或合并精神心理异常表现的情况,将有助于改进治疗和慢病管理策略。临床医师在处理老年GERD时应该建立包含消化心身诊疗理念在内的整体医学观念,创建基于患者感受的良好医患沟通和信任关系。此外,合理地应用具有消化心身疾病专科特色的神经递质调节药物能够提升老年GERD患者的处置水平和临床疗效。
Gastroesophageal reflux disease(GERD)has become one of the most common gastrointestinal(GI)diseases in the elderly,with a rise in the incidence of GERD.Psychological factors and abnormal interaction of“brain-gut axis”are associated with the key pathogenesis of GERD in the elderly,including weakened anti-reflux barrier at gastro esophageal junction,abnormal esophageal motility and visceral hypersensitivity.Early identification and evaluation of psychological factors are vital to improve treatment and chronic disease management strategies for elderly GERD patients.Clinicians should establish an overall medical concept,which including the concept of psychosomatic digestive disorders and create a good relationship of physician-patient communication based on patients′feelings when dealing with GERD in the elderly.In addition,the rational use of neurotransmitter regulating drugs characterized by digestive psychosomatic diseases can improve the disposal level and clinical efficacy for elderly GERD patients.
作者
吴碧玉
陈胜良
Wu Biyu;Chen Shengliang(Department of Gastroenterology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai Institute of Digestive Disease,Shanghai 200127,China)
出处
《中国临床保健杂志》
CAS
2022年第2期157-160,共4页
Chinese Journal of Clinical Healthcare
关键词
胃食管反流
精神障碍
身心疗法
整体保健
老年人
Gastroesophageal reflux
Mental disorders
Mind-body therapies
Holistic health
Aged
