103例难治性胃食管反流病临床特征分析  

Analysis on Clinical Characteristic of 103 Cases of Refractory Gastroesophageal Reflux Disease

作　　者：刘春芳[1] 程艳梅[1] 曹会杰[1] 王宏伟[1] 张秀莲[1] 朱生樑[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海市虹口区甘河路110号200437

出　　处：《中医杂志》2016年第6期504-507,526,共5页Journal of Traditional Chinese Medicine

基　　金：上海市科学技术委员会科研计划项目(13401902800)

摘　　要：目的探讨难治性胃食管反流病的临床特征。方法将质子泵抑制剂治疗有效的胃食管反流病患者51例作为对照组,无效的103例作为难治组。观察两组患者一般资料、胃食管反流病相关症状,采用焦虑自评量表(SAS)及抑郁自评量表(SDS)评定患者精神心理状况,并进行胃镜观察,记录患者幽门螺旋杆菌感染情况及胃镜下食管黏膜炎症分级、Barrett食管情况。结果两组患者性别、年龄、病程、体重指数比较差异均无统计学意义(P>0.05)。难治组患者胸骨后疼痛、嗳气、咽喉梗阻感、呛咳症状及气郁痰阻证的发生率明显高于对照组,烧心的发生率低于对照组(P<0.05)。难治组合并焦虑、抑郁患者数明显多于对照组(P<0.05)。两组患者胃镜下食管黏膜炎症分级、Barrett食管及合并幽门螺旋杆菌感染数比较差异无统计学意义(P>0.05)。结论与质子泵抑制剂治疗有效的胃食管反流病患者相比,难治性胃食管反流病患者临床多表现为疼痛、嗳气、咽喉梗阻感、呛咳,气郁痰阻证多,较易合并心理疾患。Objective To explore and discuss the clinical characteristic of refractory gastroesophageal reflux disease. Methods Fifty-one patients with gastroesophageal reflux disease,treated with proton pump inhibitor which turned to be effective,were taken as the control group,while 103 ineffective cases were taken as the refractory group.Observed normal information,related symptoms of gastroesophageal reflux disease of patients in two groups. Adopted self-rating anxiety scale（ SAS） and self-rating depression scale（ SDS） to evaluated patients＇ mental and psychological state. Conducted gastroscopic observation. Recorded Helicobacter pylori infection condition,esophageal mucosa inflammation grading under gastroscope and Barrett esophagus condition. Results The difference of gender,age,disease course and body mass index of patients between two groups no statistical significance（ P〈0. 05）. The occurrence rate of patients＇ poststernal pain,belching,laryngeal obstruction feel,bucking and coughing symptom and phlegm blockage with Qi stagnation syndrome of the refractory group was remarkably higher than that of the control group,while that of heartburn was lower than the control group（ P〈0. 05）. The number of patients combined with anxiety and depression in the refractory group was remarkably more than that of the control group（ P〈0. 05）. The difference of esophageal mucosa inflammation grading under gastroscope,Barrett esophagus and the number of combing Helicobacter pylori infection between two groups had no statistical significance（ P〈0. 05）. Conclusion Compared with patients with gastroesophageal reflux disease treated with proton pump inhibitor which turned to be effective,the clinical manifestation of patients with refractory gastroesophageal reflux disease was mostly pain,belching,laryngeal obstruction feel,bucking and coughing symptom,and phlegm blockage with Qi stagnation syndrome. These patients were more easily to be have psychological diseases.

关 键 词：难治性胃食管反流病 质子泵抑制剂 气郁痰阻证 焦虑 抑郁 

分 类 号：R571[医药卫生—消化系统]