心理因素与慢性胃炎症状的相关性研究

发布时间：2018-04-07 16:11

本文选题：慢性胃炎　切入点：胃肠道症状　出处：《宁夏医科大学》2017年硕士论文

【摘要】：目的本研究通过分析慢性胃炎患者合并焦虑、抑郁对胃肠道症状的影响以及了解胃镜下黏膜表现的特点,拟提高临床早期识别慢性胃炎患者存在精神心理异常的能力,并对患者进行适当的心理干预。方法研究纳入了2016年3月至2016年12月在宁夏医科大学总医院消化内科专家门诊就诊的120例慢性胃炎患者,对其进行问卷调查,且有≥6个月的完整门诊记录。所有研究对象均签署知情同意书,通过收集、整理所有患者的门诊详细资料,并详细记录患者的胃镜资料。由专业培训过的研究者采用观察或交谈的方式对患者进行问卷调查,内容包括14项汉密尔顿焦虑量表(HAMA)、24项汉密尔顿抑郁量表(HAMD)、15项胃肠道症状分级评分表(GSRS)。所收集资料最后均录入SPSS统计软件,分析精神心理因素与胃肠道症状之间的关系。结果1.研究人群的一般资料分析120例慢性胃炎患者中,男女比例1:0.74,平均年龄39.6岁,以25~60岁居多。2.慢性胃炎患者的胃肠道症状120例患者其中有一项或以上的胃肠道道症状108例(90%),共包含5个维度,其中消化不良、腹痛、反流维度的得分最高,得分分别为521分、496分、386分,而便秘和腹泻维度的得分最低,得分分别为66分、49分。3.慢性胃炎患者的精神心理状态3.1 120例慢性胃炎患者的HAMA的评分为15.64±5.99、HAMD的评分为15.96±7.42,男性和女性患者的HAMA的评分分别是15.59±5.45,15.71±6.72,差异无统计学意义(t=0.100,p=0.920);男性和女性患者的HAMD的评分分别是15.75±7.21,16.24±7.76,差异无统计学意义(t=0.350,p=0.727)。3.2 GSRS得分和HAMA、HAMD评分的相关性:慢性胃炎患者的GSRS总分和HAMA、HAMD的评分呈正相关(r=0.194、0.190,p=0.034、0.037)。3.3 98例合并精神心理异常(焦虑和抑郁或抑郁)的慢性胃炎患者GSRS总分及腹痛、反流、消化不良3个维度的评分明显的比22例无焦虑抑郁者高。比较胃肠道症状的发生率和GSRS评分,得出合并有精神心理异常能加重胃肠道症状的发病率,采用卡方检验比较,得出X2=4.508,P=0.034(P0.05),认为有统计学意义。48例合并中重度的焦虑的患者GSRS总分及腹痛、反流、消化不良3个维度的评分明显的比38例轻度焦虑者高。比较胃肠道症状的发生率和GSRS评分,得出明显焦虑能加重慢性胃炎的发病率,采用卡方检验比较,得出X2=5.631,P=0.018(P0.05),认为有统计学意义。4.合并精神心理异常的慢性胃炎患者的内镜表现120例慢性胃炎患者中,98例合并焦虑抑郁障碍患者的胃镜检查均存在胃炎的迹象。其中86.7%的患者显示单纯慢性非萎缩性胃炎,而无焦虑抑郁有33.3%的患者显示单纯慢性非萎缩性胃炎,采用卡方检验比较,得出X2=15.083,P=0.000(P0.01),认为有统计学意义。在本研究中,发现48例中重度焦虑患者中有76.9%的患者胃镜检查提示慢性非萎缩性胃炎,与轻度焦虑患者相比无显著差异。结论1.慢性胃炎患者常合并精神心理异常,患者的胃肠道症状与合并精神心理异常的状态明显相关2.焦虑的程度与胃肠道症状的发生率成正比。3.慢性胃炎合并精神心理因素与内镜下胃黏膜表现有一定的相关性。
[Abstract]:Objective to analyze the chronic gastritis patients with anxiety through this study, the effect of depression on gastrointestinal symptoms and investigate the characteristics of gastric mucosal manifestations, to improve the clinical early identification of chronic gastritis patients have abnormal psychological ability, and the patients with psychological intervention appropriate. Methods included in the study from March 2016 to December 2016 in 120 cases of chronic gastritis in the General Hospital of Ningxia Medical University Department of Gastroenterology specialist outpatient, on the questionnaire survey, and there are more than 6 months of complete outpatient records. All subjects signed informed consent, through collecting, sorting all patients with clinic data, and detailed records of patients with gastroscopy. Researchers from professional training the conversation was observation or to conduct a questionnaire survey of patients, including 14 Hamilton Anxiety Scale (HAMA), 24 item Hamilton Depression Scale (HAMD), 15 gastrointestinal symptom score scale (GSRS). The collected data were finally using SPSS statistical software to analyze the relationship between psychological factors and gastrointestinal symptoms. Results 1. of the study population analysis of 120 cases of chronic gastritis patients, male to female ratio was 1:0.74, the average age of 39.6 years, to 25~60 at the age of mostly.2. patients with chronic gastritis and gastrointestinal symptoms in 120 patients with one or more of the gastrointestinal tract symptoms in 108 cases (90%), contains 5 dimensions, including abdominal pain, dyspepsia, reflux dimension scored the highest score was 521 points, 496 points, 386 points, and constipation and diarrhea the scores of the lowest score was 66 points, the mental state of 3.1120 patients with chronic gastritis were divided into 49.3. of chronic gastritis with HAMA score was 15.64 + 5.99, HAMD score was 15.96 + 7.42, male and female patients with HAMA score were 15.59 + 5.45 15.71, + 6.72, the difference was not statistically significant (t=0.100, p=0.920); male and female patients with HAMD score were 15.75 + 7.21,16.24 + 7.76, the difference was not statistically significant (t=0.350, p=0.727).3.2 and HAMA GSRS score, HAMD score: the correlation between chronic gastritis patients with GSRS score and HAMA score was positively related to HAMD the (r=0.194,0.190, p=0.034,0.037).3.3 98 cases with abnormal psychological factors (anxiety and depression or depression) GSRS in patients with chronic gastritis and total reflux, abdominal pain, dyspepsia 3 score significantly more than 22 patients without anxiety depression. High incidence of gastrointestinal symptoms and GSRS scores were compared, obtained with there are mental abnormalities can aggravate the incidence of gastrointestinal symptoms, compared with chi square test, obtained X2=4.508, P=0.034 (P0.05), that was statistically significant in patients with.48 GSRS score and abdominal pain, severe anxiety in patients with reflux. The 3 dimensions of bad score significantly more than 38 cases of mild anxiety. High incidence of gastrointestinal symptoms and GSRS scores were compared, the obvious anxiety can aggravate the incidence of chronic gastritis, compared with chi square test, obtained X2=5.631, P=0.018 (P0.05), believed to have statistical significance of endoscopic.4. with abnormal psychological the chronic gastritis patients showed 120 cases of chronic gastritis patients, 98 cases of gastroscopy patients combined with anxiety and depression are signs of gastritis. In 86.7% patients with simple chronic non atrophic gastritis, without anxiety and depression in 33.3% patients with simple chronic non atrophic gastritis, compared with chi square test, the X2=15.083, P=0.000 (P0.01), was considered statistically significant. In this study, 48 cases were found in patients with severe anxiety in 76.9% patients with gastroscopy showed chronic non atrophic gastritis, mild anxiety and suffering Compared with no significant difference. Conclusion patients with 1. chronic gastritis is often associated with psychological abnormalities in patients with gastrointestinal symptoms and accompanied by abnormal psychological state of anxiety was related to 2. degree and the incidence of gastrointestinal symptoms with the related expression of gastric mucosa..3. chronic gastritis combined with psychological factors and in the microscope.

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573.3

【相似文献】