焦虑会影响功能性消化不良时胃部的感官动作功能


  May 23, 2005 (芝加哥) - 消化性疾病周报的2005年会议中有一项发表,一项由比利时鲁汶大学所进行的研究结果显示,在功能性消化不良症候群(FD)中,内脏的过敏现象会产生心理焦虑,而此焦虑指数会关系到胃部的敏感度及顺从度,这个现象证实了过敏与心理因子之间的关连性;同时也强化了一项假设,亦即,中枢神经系统在内脏敏感症里,扮演了一项重要的角色。
  
  根据鲁汶大学的Lukas Van Oudenhove医师表示,本项研究的对象为功能性消化不良的患者,目的在于评估焦虑是否会关系到胃部的病理机转,其中,敏感度正常者及过敏者又有何不同;社会心理因子会产生症状,使症状恶化,而且会影响到治疗的效果;在功能性消化不良与心理疾病之间,有著很高的合并症比率;本研究专注在胃痛、过敏,与社会心理因素之间的关连,如创伤等。
  
  本研究招募了92位患者参与试验,其中64位为女性,平均年龄为40±2.5岁;在恒压球胃部过敏试验前后,患者们皆完成了美国版的焦虑心理特质衡量(STAI),这是对于短暂焦虑的测量方式;恒压试验前后的平均STAI指数,则代表了焦虑的心理状态,患者们也完成了荷兰版的STAI,这是将焦虑视为长期性格特质的一项测量法。
  
  费城天普大学的医学教授Benjamin Drevsky医师表示,这是一项有趣的研究,因为使用恒压试验对焦虑的影响作评估,是一项很好的定量方式,人们通常注重在焦虑的症状,而忽略了胃部的感受;敏感性与焦虑之间的关连,可以帮助我们了解功能性消化不良与焦虑之间的关系。
  
  在STAI状态指数与不适感的起始值之间,研究人员发现了微弱却很明显的关连性;在60位敏感度正常的次试验组中,焦虑指数与胃部测量值之间并无明显的关连;在32位过敏患者中,STAI指数与胃部顺从度之间,有著明显的逆向关连性,同样的情况可见于STAI状态指数与不适-疼痛起始值之间;过敏者与敏感度正常者两组之间,并未显示出过大的差异,但是,过敏患者有著较低的胃部顺从性;所有的试验次组中,胃部的容纳度皆与焦虑指数无关。
  
  Van Oudenhove向Medscape表示,对于评估功能性消化不良患者的焦虑程度,及药物或心理治疗的决定,本研究的发现将会越显重要;大部分的肠胃病专家皆熟知焦虑症状与其对功能性消化不良治疗的影响;在检视患者的焦虑程度时,他们可以使用STAI问卷作为开始。
  
  科学研究基金会(The Fund for Scientific Research - Flanders)为本研究的资助单位。

Anxiety Influences Gastric Sen

By
Medscape Medical News

Laura Gater

May 23, 2005 (Chicago) — In functional dyspepsia (FD), gastric sensitivity and compliance are related to state anxiety scores in visceral hypersensitivity, confirming the association of hypersensitivity with psychological factors and strengthening the hypothesis that the central nervous system plays a key role in visceral hypersensitivity, according to investigators in a study from the University of Leuven in Leuven, Belgium. The results were presented here at Digestive Disease Week 2005.

The study's objective was to assess whether anxiety is associated with gastric pathophysiologic mechanisms in normosensitive vs hypersensitive FD patients, according to Lukas Van Oudenhove, MD, University of Leuven. The psychosocial factors associated with FD precede onset and exacerbation and influence treatment outcomes. There is a high comorbidity between FD and psychiatric disorders. The study looked at the association of gastric pain, hypersensitivity, and psychosocial factors, such as trauma.

Ninety-two patients were involved in the study, 64 of whom were women. The mean age of patients was 40 ± 2.5 years. Both before and after gastric sensitivity testing with a barostat balloon, patients completed the state version of the State-Trait Anxiety Inventory (STAI), which is a measure of momentary anxiety. The mean of the STAI scores before and after the barostat test was used as a measure of state anxiety. Patients also completed the Dutch version of the STAI, which is a measure of anxiety as a long-lasting personality trait.

"This study was interesting because the barostat testing was useful in looking at the effect of anxiety in a quantitative way. People have looked at anxiety symptoms but not gastric sensations. The association of sensitivity with anxiety levels helps us understand the relationship between FD and anxiety," said Benjamin Krevsky, MD, MPH, Professor of Medicine, Temple University in Philadelphia, Pennsylvania, who moderated the session.

Investigators found a weak but statistically significant correlation in the whole group between the STAI-state score and the discomfort threshold. In the normosensitive subgroup of 60 patients, no significant correlation was found between anxiety scores and gastric measures. In the 32 hypersensitive patients, there was a significant negative correlation between STAI-state scores and gastric compliance, as well as between STAI-state scores and discomfort-pain threshold. Anxiety scores between the hypersensitive and the normosensitive groups did not show much difference, but hypersensitive patients did have lower gastric compliance. In all of the subgroups, gastric accommodation was not related to anxiety scores.

"These findings will become more important in properly evaluating anxiety levels in FD patients and in treating them either pharmacologically or psychiatrically," Dr. Van Oudenhove told Medscape. "Most gastroenterologists are familiar with anxiety diseases and their impact on FD treatment. They can use the STAI questionnaire as a place to start when looking at patients' anxiety levels."

Grant and research support were provided by The Fund for Scientific Research – Flanders (FWO-Vlaanderen).

DDW 2005: Abstract 848. Presented May 18, 2005.

Reviewed by Gary D. Vogin, MD

Laura Gater is a freelance writer for Medscape.

    
相关报导
饮食中提早摄取蛋类并不会降低过敏风险
2016/9/9 上午 11:22:00
忧郁和焦虑会缩短IBD突发时间
2016/2/26 上午 10:55:00
儿童时期之过敏可预测内化行为
2016/1/22 上午 10:50:10

上一页
   1   2   3   4   5   6   7   8   9   10  




回上一页