Iurenev G L, Sirota N A, Dicheva D T, Bitkova E N, Maev I V
Ter Arkh. 2014;86(8):42-9.
To evaluate the efficiency of psychotherapeutic methods on the clinical course of gastroesophageal reflux disease (GERD), quality of life (QL), esophagogastroduodenoscopic findings and 24-hour pH monitoring readings in patients with this condition.
Sixty patients with GERD were divided into equal groups according to performed therapy: standard drug treatment or its combination with psychotherapeutic methods. The investigators estimated the degree of esophageal mucosal damage by esophagogastroduodenoscopy, esophageal acidity by 24-hour pH monitoring, and the magnitude of clinical manifestations by the Likert scale and assessed QL by the SF-36 questionnaire. The psychoemotional health component was analyzed using the clinical questionnaire for the identification and evaluation of neurotic states (CQIENS), the Leonhard-Shmichek characterological questionnaire, and the individual typological questionnaire.
The patients with GERD were found to have individual personal traits and a definite psychological response. Incorporation of psychotherapeutic methods into the combination therapy was ascertained to have an additional therapeutic effect against the clinical manifestations of GERD, psychological responses in the patients, and QL indicators. There was a direct relationship between the psychological component of QL and the data of the CQIENS questionnaire. The most significant correlation was found between the CQIENS anxiety scores and the psychological component of QL (r = 0.73; p = 0.00004). Correlation analysis in the patients with GERD showed a relationship between the CQIENS anxiety scores and the clinical index (r = -0.68; p = 0.0001).
The use of psychotherapeutic methods in addition to standard drug therapy improves both the physical and psychological states in patients with GERD and has some impact on a reduction in the magnitude of clinical symptomatology. This may contribute to the prompter recovery of patients and create prerequisites for improving their QL.
评估心理治疗方法对胃食管反流病（GERD）患者临床病程、生活质量（QL）、食管胃十二指肠镜检查结果及24小时pH监测读数的影响。
60例GERD患者根据所接受的治疗分为两组：标准药物治疗组或标准药物治疗联合心理治疗组。研究人员通过食管胃十二指肠镜检查评估食管黏膜损伤程度，通过24小时pH监测评估食管酸度，通过李克特量表评估临床表现的严重程度，并通过SF - 36问卷评估QL。使用神经症状态识别与评估临床问卷（CQIENS）、莱昂哈德 - 施米切克性格问卷和个体类型问卷分析心理情绪健康成分。
发现GERD患者具有个体特质和明确的心理反应。确定将心理治疗方法纳入联合治疗对GERD的临床表现、患者的心理反应和QL指标具有额外的治疗效果。QL的心理成分与CQIENS问卷数据之间存在直接关系。在CQIENS焦虑评分与QL的心理成分之间发现了最显著的相关性（r = 0.73；p = 0.00004）。GERD患者的相关分析表明CQIENS焦虑评分与临床指标之间存在关系（r = -0.68；p = 0.0001）。
除标准药物治疗外使用心理治疗方法可改善GERD患者的身体和心理状态，并对减轻临床症状的严重程度有一定影响。这可能有助于患者更快康复，并为提高其QL创造前提条件。
