服药信念干预在服用抗抑郁药物的功能性消化不良患者中的应用效果  

Effects of medication beliefs intervention on dyspepsia symptoms and quality of life in functional dyspepsia patients taking antidepressants

作　　者：王茜 明文[1] 张红[1] 袁源 贺国斌[1] WANG Xi;MING Wen;ZHANG Hong;YUAN Yuan;HE Guobin(Department of Gastroenterology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院消化内科,四川南充637000

出　　处：《医药前沿》2023年第23期27-31,35,共6页Journal of Frontiers of Medicine

基　　金：四川省医学科研课题计划(2021XHNJ05);川北医学院校级科研发展基金项目(CBY22-QNA59)。

摘　　要：目的:探讨服药信念干预在服用抗抑郁药物的功能性消化不良(FD)患者中的应用效果。方法:本研究为自身前后对照研究,选取2017年1月—2022年3月于川北医学院附属医院消化内科门诊诊断为FD的服用抗抑郁药物的患者327例,针对患者对抗抑郁药的不良认知及消极态度给予为期1年的认知干预。最终共269例(82.3%)患者完成了为期1年的随访研究。在干预前及干预1年后用服药信念特异性问卷、尼平消化不良指数简表(NDI)、消化不良症状严重度量表(DSS)、广泛性焦虑障碍量表(GAD-7)、患者健康问卷抑郁症状群量表(PHQ-9)、改编的患者健康问卷躯体症状群量表(PHQ-15)分别评价患者的特异性服药信念、生命质量、消化不良症状、焦虑、抑郁、躯体化症候群。比较干预后必要性信念无明显降低组患者(n=109)与明显降低组患者(n=160)的DSS、NDI、GAD-7、PHQ-9、PHQ-15评分,并比较顾虑信念无明显降低组患者(n=128)与明显降低组患者(n=141)的DSS、NDI、GAD-7、PHQ-9、PHQ-15评分。结果:干预后,269例FD患者必要性信念中②、③、④条目以及顾虑信念中⑥、⑦、⑧、⑨条目得分低于干预前,差异有统计学意义(P<0.05)。干预后,269例FD患者焦虑、抑郁、躯体化、DSS、NDI得分均低于干预前,差异均有统计学意义(P<0.05)。其中必要性信念明显降低组160例,无明显降低组109例,干预前,两组DSS、NDI得分比较,差异均无统计学意义(P>0.05);干预后,两组DSS、NDI得分比较,差异无统计学意义(P>0.05);干预后,必要性信念明显降低组患者PHQ-15评分高于无明显降低组患者,差异有统计学意义(P<0.05);两组患者GAD-7、PHQ-9评分比较,差异无统计学意义(P>0.05)。其中顾虑信念明显降低组141例,无明显降低组128例,干预前,两组DSS、NDI得分比较,差异均无统计学意义(P>0.05);干预后,顾虑信念明显降低组患者的DSS、NDI得分均低于无明显降低组患�Objective To explore the application effect of medication belief intervention in patients with functional dyspepsia(FD)taking antidepressant drugs.Methods This study was a self-controlled study.A total of 327 FD patients who were diagnosed with taking antidepressant drugs in the outpatient Department of Gastroenterology of the Affiliated Hospital of North Sichuan Medical College from January 2017 to March 2022 were selected as the research objects.A total of 269 patients(82.3%)completed the 1-year follow-up study.Before and 1 year after the intervention,the specificity of the patients,quality of life,dyspepsia,anxiety,depression and somatization syndrome were evaluated respectively by the Belief about Medication Questionnaire,Nepean Dyspepsia Index-Short Form(NDI),Dyspepsia Symptom Severity Scale(DSS),Generalized Anxiety Disorder-7,(GAD-7),Patient Health Questionnaire-9(PHQ-9)and adapted Patient Health Questionnaire-15(PHQ-15).The scores of DSS,NDI,GAD-7,PHQ-9 and PHQ-15 were compared between patients with no significant reduction of necessity belief(n=109)and patients with significant reduction(n=160)after intervention.The scores of DSS,NDI,GAD-7,PHQ-9,and PHQ-15 were compared between patients with no significant reduction of concern belief(n=128)and patients with significant reduction of concern belief(n=141).Results After intervention,the scores of②,③,and④items of necessity belief and⑥,⑦,⑧,and⑨items of concern belief of 269 FD patients were lower than those before intervention,and the differences were statistically significant(P<0.05).After the intervention,the scores of anxiety,depression,somatization,DSS and NDI of 269 FD patients were lower than those before the intervention,and the differences were statistically significant(P<0.05).There were 160 cases in the significantly reduced necessity belief group and 109 cases in the non-significantly reduced necessity belief group.Before intervention,there were no statistically significant differences in DSS and NDI scores between the two groups(P>0.0

关 键 词：功能性消化不良 服药信念 必要性信念 顾虑信念 消化不良症状严重度 生命质量 

分 类 号：R723.11[医药卫生—儿科]