嗳气症患者的症状特点及心理社会因素分析  

Symptomatic features and psychosocial factors in patients with belching disorders

作　　者：孙晓敏[1] 柯美云[1] 王智凤[1] 张静[1] 方秀才[1] 朱丽明[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,100730

出　　处：《中华医学杂志》2012年第32期2252-2255,共4页National Medical Journal of China

基　　金：国家“十一五”科技支撑计划（2007BAl04801）;上海市卫生局资助项目（20114309）

摘　　要：目的问卷调查分析嗳气症的症状特点和心理社会因素。方法对北京协和医院消化内科门诊2010年9月至2011年1月连续入组的反复嗳气患者21例进行问卷调查，内容包括一般资料、症状谱、病程、发病诱因、既往诊疗情况、心理社会情况、精神心理状态和人格等。采用Pearson相关分析及确切概率法分析数据。结果20例符合嗳气症诊断标准，其中男5例、女15例；年龄（49±10）岁。18例患者每天发作嗳气，16例嗳气与进餐有关；15例嗳气不需自行诱导，16例嗳气可以控制；17例有重叠症状，功能性消化不良最为常见（13例），其次为胃食管反流病（11例）；16例患者有精神刺激或负性事件的经历，其中，13例与家庭关系紧张、工作压力大及过度劳累有关；12例存在焦虑和（或）抑郁状态；8例具有神经质人格特征。重叠症状的数量与焦虑状态相关（r=0．47，t=2．14，P〈0．05），嗳气严重程度与是否有焦虑抑郁状态无相关关系（P=0．096）。结论嗳气症患者有多种临床表现，其与隋绪改变、环境应激有关，多合并精神心理及人格特征异常。嗳气可能是患者对消化道不适症状的一种行为异常反应，心理社会因素在嗳气症发病机制中可能具有重要作用。Objective To explore the symptomatic features and psychosocial factors in patients with belching disorders. Methods At Peking Union Medical College Hospital Outpatient Clinic from September 2010 to January 2011, 21 consecutive patients with repetitive belching were profiled by symptom questionnaires, including general demographics, spectrum of symptoms, disease course, predisposing factors, previous treatment, psyehosocial factors, mental status and personality traits, etc. Pearson＇s correlation analysis and exact probability were used. Results Among them, 20 patients fulfilled the Rome Ⅲ criteria of belching disorders. There were 5 males and 15 females with an age range of （49 ± 10）years. Among them, the belching patterns were daily （ n = 18 ）, meal-related （ n = 16 ）, spontaneous （ n = 15 ）, controllable （ n = 16） and symptomatic overlapping （ n = 17 ）. The most common symptoms were functional dyspepsia （FD） （ n = 13 ） and gastroesophageal reflux disease （GERD） （ n = 11 ）. Sixteen patients experienced mental stimulation/negative events and 13 patients were related to family tension, work stress and overwork. There were 12 patients with anxiety and/or depression and 8 with neurotic personality. The number of overlapping symptoms was related to anxiety states （ r = 0. 47, t = 2. 14, P 〈 0. 05 ）. But the severity of belching was unrelated to with or without depression and anxiety state （ P = 0. 096）. Conclusions There are a variety of clinical manifestations in patients with belching disorders. Belching disorders is often related to emotional change and environmental stress and accompanied by abnormal mental and personality characteristics. Belching may be an abnormal behavior reaction to gastrointestinal discomfort symptoms. The psychological and social factors probably play an important role in the pathogenesis of belching disorders.

关 键 词：嗳气 心理学 社会 临床特点 

分 类 号：R256.3[医药卫生—中医内科学]