Madisch A, Kulich K R, Malfertheiner P, Ziegler K, Bayerdörffer E, Miehlke S, Labenz J, Carlsson J, Wiklund I K
Medical Department I, Technical University of Dresden, Dresden, Germany.
Z Gastroenterol. 2003 Dec;41(12):1137-43. doi: 10.1055/s-2003-45277.
The clinical and socioeconomic burden of gastro-esophageal reflux disease (GERD) is considerable. The primary symptom of GERD is heartburn, but it may also be associated with extraesophageal manifestations, such as asthma, chest pain and otolaryngologic disorders.
To describe the impact of heartburn on patients' Health-Related Quality of Life (HRQL) in Germany, using validated generic and disease-specific instruments to measure patient-reported outcomes.
Patients with symptoms of heartburn completed the German versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), the Short Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. Frequency and severity of heartburn during the previous 7 days were also recorded.
142 consecutive patients completed the assessments (mean age of 47.5 years, SD = 14.6; 55.6 % female). 70 % of patients had moderate symptoms. Over half (68 %) had symptoms on more than 4 days in the previous week. Patients were most bothered by symptoms of reflux with a mean GSRS score, (ranges from 1 [not bothered] to 7 [very bothered]), of 3.9, indigestion of 3.3 and abdominal pain of 3.0, respectively. As a result of their symptoms, patients experienced problems with food and drink. The mean QOLRAD score (ranges from 1 to 7; the lower the value the more severe the impact on quality of life) of daily functioning was 4.4, impaired vitality 4.6, emotional distress 5.0 and sleep disturbance 5.1, respectively. This led to impaired overall HRQL across all domains (mean SF-36 score of this heartburn population compared to a general population in Germany). Using HAD, 25 % of patients were anxious and 8 % were depressed.
There is consistent evidence that heartburn substantially impairs all aspects of health-related quality of life.
胃食管反流病（GERD）的临床和社会经济负担相当大。GERD的主要症状是烧心，但它也可能与食管外表现有关，如哮喘、胸痛和耳鼻喉疾病。
使用经过验证的通用和疾病特异性工具来测量患者报告的结果，描述烧心对德国患者健康相关生活质量（HRQL）的影响。
有烧心症状的患者完成了德文版的胃肠道症状评分量表（GSRS）、反流和消化不良生活质量问卷（QOLRAD）、简短健康调查问卷（SF-36）和医院焦虑抑郁量表（HAD）。还记录了前7天烧心的频率和严重程度。
142例连续患者完成了评估（平均年龄47.5岁，标准差=14.6；55.6%为女性）。70%的患者有中度症状。超过一半（68%）的患者在前一周有4天以上出现症状。患者最困扰的是反流症状，GSRS平均评分为3.9（范围从1[无困扰]到7[非常困扰]），消化不良为3.3，腹痛为3.0。由于这些症状，患者在饮食方面出现问题。日常功能的QOLRAD平均评分为4.4（范围从1到7；分值越低对生活质量的影响越严重），活力受损为4.6，情绪困扰为5.0，睡眠障碍为5.1。这导致所有领域的总体HRQL受损（与德国普通人群相比，该烧心人群的SF-36平均评分）。使用HAD量表，25%的患者焦虑，8%的患者抑郁。
有一致的证据表明，烧心会严重损害健康相关生活质量的各个方面。
