功能性消化不良不同亚组焦虑抑郁和胃容受性及内脏敏感性研究  

Study on anxiety,depression,gastric accommodation and visceral sensitivity of different functional dyspepsia subgroups

作　　者：成家飞[1] 朱滢[2] 许丰 CHENG Jia-fei;ZHU Ying;XU Feng(Department of Gastroenteroiogy,Jiangsu Province Hospital of TCM,Nanjing 210000,China;Department of Gastroenterology,Subei People's Hospital of Jiangsu Province,Yangzhou 225001,China;Department of Gastroenterology,Yinzhou Hospital Affiliated to Medical School of Ningbo University,Ningbo 315040,China)

机构地区：[1]江苏省中医院消化科,江苏南京210000 [2]苏北人民医院消化科,江苏扬州225001 [3]宁波大学医学院附属鄞州医院消化科,浙江宁波315040

出　　处：《中国中西医结合消化杂志》2018年第11期955-960,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨功能性消化不良(FD)不同亚组焦虑抑郁、胃容受性及内脏敏感性的差异及其与症状之间的相关性。[方法]共纳入93例研究对象,其中健康对照组(HC)36例,FD组57例,根据罗马Ⅳ标准将FD进一步分为:上腹痛综合征(EPS)11例,餐后不适综合征(PDS)35例,重叠组11例。各组人群均填写消化不良症状问卷和医院焦虑抑郁量表(HAD)。采用液体营养餐试验评估胃容受性,视觉模拟评分法(VAS)评估内脏敏感性,并运用Spearman秩相关分析探讨这些病理生理机制与消化不良症状之间的相关性。[结果]FD 3个亚组焦虑评分较HC组均升高(P<0.01),EPS组和重叠组的抑郁评分较HC组升高(P<0.01,P<0.05),而PDS组的抑郁评分与HC组差异无统计学意义(P>0.05),3个亚组间焦虑、抑郁评分无明显差异(P>0.05)。与HC组比较,EPS组、PDS组及重叠组的MTV均降低(811.8±197.8,810.9±193.6,766.4±225.9950.8±193.1;P<0.05,P<0.01,P<0.01),FD 3个亚组之间的MTV差异无统计学意义(P>0.05)。液体营养餐后,EPS组、PDS组和重叠组的饱胀评分下降速度较HC明显减慢,但FD 3个亚组间下降速度差异无统计学意义(P>0.05);仅重叠组较HC组出现恶心、腹痛的比例明显升高(P<0.05),FD 3个亚组间差异无统计学意义(P>0.05)。EPS组:症状总分与焦虑呈正相关(r=0.603,P=0.049),上腹烧灼感与餐后30min饱胀VAS评分呈负相关(r=-0.759,P=0.007)。PDS组:餐后饱胀评分和症状总分分别与焦虑、抑郁及餐后30min饱胀评分均呈正相关(r=0.407,P=0.015;r=0.405,P=0.016;r=0.390,P=0.021;r=0.382,P=0.023;r=0.462,P=0.005;r=0.359,P=0.034)。重叠组:症状与各参数之间均无相关性(P>0.05)。[结论]虽然与HC组比较,FD患者存在焦虑抑郁、胃容受性受损及内脏高敏感,但3个亚组间这些病理生理机制均无明显差异。各亚组症状与病理生理机制之间的相关性并不一致。[Objective]To explore the differences in anxiety,depression,gastric accommodation and visceral sensitivity among different functional dyspepsia(FD)subgroups and the correlation between symptoms and these pathophysiological mechanisms.[Methods]A total of 93 participants were enrolled in this study,including 36 healthy controls(HC)and 57 FD patients.We further divided 57 FD patients into epigastric pain syndrome(EPS,n=11),postprandial distress syndrome(PDS,n=35)and overlap groups(n=11)according to Rome IV criteria.All subjects completed a questionnaire of FD symptoms and a table of hospital anxiety and depression scale(HAD).Gastric accommodation was measured using liquid nutrient drink test(LNDT).Visceral sensitivity was determined using visual analogue scale(VAS).Meanwhile,spearman correlation analysis was used to examine the relationship between these pathophysiological mechanisms and FD symptoms.[Results]The score of anxiety was higher in all three FD subgroups compared with HC(all P<0.01).EPS and overlap groups showed increased score of depression compared with HC(P<0.01,P <0.05 respectively).However,there was no difference in depression score between PDS group and HC group(P>0.05).No difference was found in anxiety or depression score among the three FD subgroups.We observed a higher MTV in EPS,PDS,and overlap groups compared with HC(811.8±197.8,810.9±193.6,766.4±225.9 VS 950.8±193.1;P<0.05,P<0.01,P<0.01 respectively).There was no difference in MTV among these three subgroups(P>0.05).The score of fullness after LNDT declined more slowly in all three FD subgroups in comparison to HC.Again,no difference was found among the three FD subgroups(P >0.05).Only overlap group(not EPS or PDS group)tended to have a higher percentage of nausea and abdominal pain compared with HC.No statistical difference was detected among three FD subgroups.In EPS group,apositive correlation was noted between total symptoms score and anxiety(r=0.603,P=0.049),and a negative one was observed between epigastric burning and VAS of fullne

关 键 词：功能性消化不良 焦虑 抑郁 胃容受性 内脏高敏感 

分 类 号：R723.1[医药卫生—儿科]