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目的:分析伴有情感障碍的肠易激综合征(irritable bowel syndrome,IBS)患者的睡眠质量,探讨心理疏导和氟哌噻吨美利曲辛片(商品名:黛力新)对IBS患者睡眠质量的影响。方法:采用罗马Ⅲ标准诊断IBS,对符合纳入标准的伴有情感障碍的IBS患者予阿森斯睡眠障碍量表(Athens insomnia scale,AIS)、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(selfrating depression acale,SDS)进行自我评估。随机分组后,对照组采用一般对症治疗,观察组在对症处理基础上加心理疏导和黛力新治疗2个月。再次对研究对象进行问卷调查,观察两组患者治疗后睡眠质量的差异。另随机选取行健康体检者(体检组)作治疗前对比研究。结果:伴有情感障碍的IBS患者的AIS总均分为5.9±2.7,睡眠障碍发生率为36.5%(23/63),均显著高于体检组(P<0.05)。SDS总标准分IBS组与体检组比较,差异有统计学意义(P<0.05),IBS组高于体检组;而SAS总标准分IBS组与体检组比较,差异无统计学意义(P>0.05)。治疗后观察组AIS、SDS总标准分和失眠率均低于治疗前,差异均有统计学意义(P<0.05);而SAS总标准分治疗前后比较差异无统计学意义(P>0.05)。结论:伴有情感障碍的IBS患者常存在睡眠障碍,AIS总均分和SDS总标准分高于体检人群;抗抑郁治疗可改善部分IBS患者的睡眠质量。
Objective: To analyze the quality of sleep in patients with irritable bowel syndrome (IBS) accompanied by affective disorder and to explore the relationship between psychological counseling and flupentixol / melitracen tablets (brand name: Quality impact. Methods: The IBS patients with affective disorder who met the inclusion criteria were assessed with Roman Ⅲ criteria for Athens insomnia scale (AIS), self-rating anxiety scale (SAS) And self-depression depression scale (SDS). After randomization, the control group was treated with general symptomatic treatment. The observation group was treated with psychotherapy and Deanxit on the basis of symptomatic treatment for 2 months. Questionnaires were again conducted on the subjects to observe the differences in sleep quality between the two groups after treatment. Another randomly selected health examination (examination group) for comparison before treatment. Results: The overall mean AIS score of IBS patients with affective disorder was 5.9 ± 2.7 and the incidence of sleep disorders was 36.5% (23/63), both of which were significantly higher than those of the physical examination group (P <0.05). There were significant differences between the SDS total score IBS group and the physical examination group (P <0.05), the IBS group was higher than the physical examination group, but there was no significant difference between the SAS total score IBS group and the physical examination group (P> 0.05 ). After treatment, the total score of AIS, SDS and insomnia in observation group were lower than those before treatment (P <0.05). However, there was no significant difference between before and after treatment (P> 0.05). CONCLUSIONS: Patients with IBS associated with affective disorders often have sleep disorders, with a higher total AIS and SDS score than those in the physical examination. Antidepressant therapy may improve sleep quality in some IBS patients.