谢昆华+唐尚伟+杨志寨+颜钟生+陈钦源+邓达玲

【摘要】 目的：对幽门螺杆菌（helicobacter pylori，Hp）感染功能性消化不良（functional dyspepsia，FD）伴焦虑者根除Hp治疗，研究根除Hp治疗的必要性。方法：选择85例FD伴焦虑症状Hp感染患者，分为治疗组42例和对照组43例，治疗组在常规治疗的的基础上进行根除Hp治疗，对照组采用常规治疗。比较两组患者治疗结束后6个月、12个月的ZUNG焦虑自评量表评分和疗效。结果：治疗6个月后，治疗组总有效率为64%，对照组为40%，两组比较差异有统计学意义（P<0.05）；治疗12个月后，治疗组总有效率为69%，对照组为43%，两组比较差异有统计学意义（P<0.05）。治疗后6个月和12个月，ZUNG焦虑自评量表评分两组比较差异均有统计学意义（P<0.01）。结论：FD伴焦虑症状的Hp感染者在常规治疗的基础上根除Hp治疗，对改善FD伴焦虑症状疗效优于常规治疗，Hp感染存在诱发或加重焦虑症状的倾向，应进行根除Hp治疗。

【关键词】 功能性消化不良； 焦虑； 幽门螺杆菌

The Curative Effect Observation of Hp Eradication Therapy for the Anxiety FD Patients with HP Infection/XIE Kun-hua，TANG Shang-wei，YANG Zhi-zhai，et al.//Medical Innovation of China，2014，11（01）：001-003

【Abstract】 Objective：To study the necessities of Hp eradicate therapy in anxiety FD patients with Hp infection.Method：85 FD with anxiety Hp infected patients were divided into 2 groups： the treatment group and the control group. The treatment group with 42 cases were accept the Hp eradicate therapy on the basis of conventional treatment， while the control group with 43 cases were just accept the conventional treatment. The indicators between the two groups were compared after treatment 6 months and 12 months， such as the effective rate， the self-rating anxiety scale of ZUNG point.Result：The total effective rate of the treatment group for 6 months was 64%， for 12 months was 69%， while the total effective rate of the control group for 6 months was 37%， for 12 months was 43%， and the difference between the two groups were all statistically significant（P<0.05）.The ZUNG self rating anxiety scale score of the treatment group for 6 months and 12 months were significant lower than the control group（P<0.01）.Conclusion：FD with anxiety patients who accept the Hp eradicated therapy on the basis of conventional treatment have a better curative effect than only accept conventional treatment. The infection of the Hp may induce or exacerbate the anxiety tendency of the FD patients. Patients infected with FD and anxiety Hp should accept the Hp eradication therapy.

【Key words】 Functional dyspepsia； Anxiety； Helicobacter pylori

First-authors address：The Peoples Hospital of Fangcheng District of Fangchenggang City，Fangchenggang 538021，China

doi：10.3969/j.issn.1674-4985.2014.01.001

功能性消化不良（functional dyspepsia，FD）是消化内科常见病之一，其发病机制尚未完全明确。目前认为许多致病因素可能与FD有关，包括：胃动力异常、内脏高敏感性、社会心理学因素、胃酸分泌过多、遗传、环境、饮食、生活方式、幽门螺杆菌（helicobacter pylori，Hp）感染等。对FD伴Hp感染患者是否要根除Hp治疗，国内学者持不同意见。本文对功能性消化不良伴焦虑Hp感染者行根除Hp治疗，探讨根除Hp治疗的必要性。

1 资料与方法

1.1 一般资料 选择2011年3月-2012年4月在本院门诊诊治的85例FD伴焦虑Hp感染患者，所有患者均完成全程跟踪。治疗组42例、对照组43例。治疗组男17例，女25例，年龄21～60岁，平均（37.5±9.5）岁，治疗前ZUNG焦虑自评量表评分（55.2±12.5）分。对照组男20例，女23例，年龄22～63岁，平均（40.5±12.1）岁，治疗前ZUNG焦虑自评量表评分（52.8±13.5）分。两组患者的年龄、性别、自评量表评分等一般资料比较差异无统计学意义（P>0.05），具有可比性。全部病例符合FD诊断标准，具有焦虑症症状，ZUNG焦虑自评量表评分>50分。

1.2 方法 对照组采用常规治疗： 多潘立酮10 mg，3 次/d，餐前30 min 口服，氟西汀10 mg，1 次/d，晨服，疗程为4周。……