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胃食管反流病症状患者并存上消化道症状对日常生活和生活质量的影响。

Effects of coexisting upper gastrointestinal symptoms on daily life and quality of life in patients with gastroesophageal reflux disease symptoms.

机构信息

Isshi Gastro-Intestinal Clinic, 2-15-21, Shinozaki-cho, Edogawa-ku, Tokyo, 133-0061, Japan.

Department of Endoscopy, The Jikei University School of Medicine, 3-15-8 Nishishinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

出版信息

Esophagus. 2021 Jul;18(3):684-692. doi: 10.1007/s10388-020-00801-1. Epub 2021 Jan 2.

Abstract

BACKGROUND AND AIM

Gastroesophageal reflux disease (GERD) is a common disease encountered in daily medical care and clinical problem which hampers daily life and reduces quality of life (QOL). The coexistence of GERD-related symptoms with the typical GERD symptoms, such as heartburn or acid regurgitation, and various upper abdominal symptoms is frequently observed in patients with GERD. However, the effect of these coexisting symptoms on the daily life and QOL of patients with GERD has not been clarified. Therefore, the effects of the various upper abdominal symptoms coexisting with GERD on the daily life and QOL of such patients were compared.

METHODS

A total of 113 newly diagnosed patients who visited our hospital with typical GERD symptoms were assessed using the modified frequency scale for the symptoms of GERD (MFSSG), gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), and short-form 8-item health survey (SF-8) questionnaires. The "gastroesophageal reflux symptom" (7 items) and "dyspepsia symptom" (7 items) groups were divided into two "typical symptoms" and two "atypical symptoms" for a total of four categories. The Pearson's correlation coefficient and multiple regression analysis were used to evaluate the correlations between each symptom category and dissatisfaction for daily life [eating, sleeping, daily activities, mood, as well as dissatisfaction for daily life-symptom subscale (SS), which is the average of the four items in the GERD-TEST, the physical component summary [PCS] and mental component summary [MCS] of the SF-8, and the influence of each symptom category on the daily life and QOL.

RESULTS

The incidences of each symptom category in patients with GERD were high: typical GERD (100%), atypical GERD symptoms (67.3%), typical functional dyspepsia (FD) (71.7%), and atypical FD (75.2%). Pearson's correlation analysis demonstrated significant correlations between each symptom category and living status (dissatisfactions of eating, sleeping, daily activities, daily life-SS) and almost all items in SF-8 (PCS, MCS) (P < 0.05). Multiple regression analysis indicated the largest influences of each symptom category on living status and QOL in descending order: dissatisfaction for eating (atypical FD, typical FD), daily activities (atypical FD, typical FD, typical GERD), mood (atypical FD), daily life-SS (atypical FD, typical FD), PCS (typical FD), and MCS (atypical FD) (P < 0.05).

CONCLUSION

Coexisting FD symptoms, particularly atypical FD symptoms, had a large influence on the impairments of daily life and decreases in QOL. Daily medical care of GERD requires attention to coexisting symptoms and their treatment instead of just focusing on the chief complaints by patients.

摘要

背景与目的

胃食管反流病(GERD)是日常医疗中常见的疾病,也是影响日常生活和降低生活质量(QOL)的临床问题。GERD 患者常同时存在 GERD 相关症状和典型 GERD 症状(如烧心或反酸)以及各种上腹部症状。然而,这些共存症状对 GERD 患者的日常生活和 QOL 的影响尚未阐明。因此,本研究比较了伴有 GERD 的各种上腹部症状对这些患者日常生活和 QOL 的影响。

方法

对 113 例因典型 GERD 症状到我院就诊的新诊断患者使用改良 GERD 症状频率量表(MFSSG)、胃食管反流和消化不良治疗效果和满意度测试(GERD-TEST)以及简短 8 项健康调查(SF-8)问卷进行评估。“胃食管反流症状”(7 项)和“消化不良症状”(7 项)组分为两组“典型症状”和两组“非典型症状”,共分为四个类别。使用 Pearson 相关系数和多元回归分析评估每个症状类别与日常生活不满(进食、睡眠、日常活动、情绪以及 GERD-TEST 中四个项目的平均值,即日常生活-症状亚量表(SS)、SF-8 的生理成分综合评分[PCS]和心理成分综合评分[MCS])以及每个症状类别对日常生活和 QOL 的影响之间的相关性。

结果

GERD 患者各症状类别的发生率均较高:典型 GERD(100%)、非典型 GERD 症状(67.3%)、典型功能性消化不良(FD)(71.7%)和非典型 FD(75.2%)。Pearson 相关分析显示,各症状类别与生活状况(进食、睡眠、日常活动、日常生活-SS 不满)和 SF-8 的几乎所有项目(PCS、MCS)之间存在显著相关性(P<0.05)。多元回归分析表明,各症状类别对生活状况和 QOL 的影响大小依次为:进食不满(非典型 FD、典型 FD)、日常活动(非典型 FD、典型 FD、典型 GERD)、情绪(非典型 FD)、日常生活-SS(非典型 FD、典型 FD)、PCS(典型 FD)和 MCS(非典型 FD)(P<0.05)。

结论

共存的 FD 症状,特别是非典型 FD 症状,对日常生活的损害和 QOL 的降低有较大影响。GERD 的日常医疗需要关注共存症状及其治疗,而不仅仅是关注患者的主要诉求。

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