腹式深呼吸训练在胃食管反流病患者中的应用研究
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摘要
目的探讨腹式深呼吸训练对胃食管反流病患者消化道症状群和心理症状群的影响。方法便利选取2017年7月—2018年2月某三级甲等医院消化科门诊的胃食管反流病患者80例,随机分为试验组和对照组,每组各40例。试验组在常规药物治疗和护理基础上,进行腹式深呼吸训练,每日2次,每次15～20 min;对照组接受常规药物治疗和护理,在干预前及干预8周后比较两组结局指标,包括症状积分、抑郁、焦虑、睡眠质量。结果干预后两组的症状积分、焦虑抑郁评分、匹兹堡睡眠质量指数总分和各维度得分(除催眠药物维度)均显著低于干预前(P<0.01)。干预后试验组的症状积分显著低于对照组(P<0.01),焦虑抑郁评分、匹兹堡睡眠质量指数总分和各维度得分(除睡眠质量、催眠药物维度)均显著低于对照组(P<0.05)。结论腹式深呼吸训练能够有效改善胃食管反流病患者消化道症状群和心理症状群。
Objective To investigate the effect of abdominal deep breathing exercises on gastrointestinal and psychological symptom clusters in patients with gastroesophageal reflux disease(GERD). Methods Eighty GERD patients were conveniently selected in a digestive outpatient clinic of a third-level grade-A hospital from July 2017 to February 2018. Patients were randomly divided into the experimental group and the control group with 40 cases in each group. Patients in the experimental group were given conventional drug therapy and routine care plus abdominal deep breathing exercises for 15～20 minutes each time,and twice a day. The control group received conventional drug therapy and routine care. The clinical outcomes including scores of symptom,depression,anxiety,and sleep quality of two groups were evaluated and compared before and 8 weeks after the intervention. Results After intervention,the scores of symptom,anxiety and depression,and Pittsburgh Sleep Quality Index(except hypnotic drug dimension) in two groups were significantly lower. After intervention,the scores of symptoms,anxiety and depression,Pittsburgh Sleep Quality Index(except sleep quality and hypnotic drug dimension) total score and score of each dimension in the experimental group were significantly lower than those in the control group(all P<0.05). Conclusion Abdominal deep breathing exercises can effectively relieve the gastrointestinal and psychological symptoms of pa-tients with GERD.
Objective To investigate the effect of abdominal deep breathing exercises on gastrointestinal and psychological symptom clusters in patients with gastroesophageal reflux disease(GERD). Methods Eighty GERD patients were conveniently selected in a digestive outpatient clinic of a third-level grade-A hospital from July 2017 to February 2018. Patients were randomly divided into the experimental group and the control group with 40 cases in each group. Patients in the experimental group were given conventional drug therapy and routine care plus abdominal deep breathing exercises for 15～20 minutes each time,and twice a day. The control group received conventional drug therapy and routine care. The clinical outcomes including scores of symptom,depression,anxiety,and sleep quality of two groups were evaluated and compared before and 8 weeks after the intervention. Results After intervention,the scores of symptom,anxiety and depression,and Pittsburgh Sleep Quality Index(except hypnotic drug dimension) in two groups were significantly lower. After intervention,the scores of symptoms,anxiety and depression,Pittsburgh Sleep Quality Index(except sleep quality and hypnotic drug dimension) total score and score of each dimension in the experimental group were significantly lower than those in the control group(all P<0.05). Conclusion Abdominal deep breathing exercises can effectively relieve the gastrointestinal and psychological symptoms of pa-tients with GERD.
引文
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[8]林三仁,许国铭,胡品津,等.中国胃食管反流病共识意见[J].中华内科杂志,2007,46(2):170-173.
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[12]刘贤臣,唐茂芹,胡蕾,等.匹兹堡睡眠质量指数的信度和效度研究[J].中华精神科杂志,1996,29(2):103-107.
[13]Mikami DJ,Murayama KM.Physiology and pathogenesis of gastroesophageal reflux disease[J].Surg Clin N Am,2015,95(3):515-525.
[14]Casale M,Sabatino L,Moffa A,et al.Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease(GERD):a systematic review[J].Eur Rev Med Pharmaco,2016,20(21):4547-4552.
[15]王苗,刘化侠,万学英,等.呼吸训练在非呼吸系统疾病中的应用现状及启示[J].中华护理杂志,2013,48(11):1030-1032.
[16]许婷,洪静芳,祝志慧.幸福疗法对肺癌患者术前焦虑抑郁症状群及主观幸福感的影响[J].广东医学,2017,38(2):325-328.
[17]Fujiwara Y,Arakawa T,Fass R.Gastroesophageal reflux disease and sleep disturbances[J].J Gastroenterol,2012,47(7):760-769.
[18]Niaz SK,Quraishy MS,Taj MA,et al.Guidelines on gastroesophageal reflux disease[J].J Pak Med Assoc,2015,65(5):532-541.
[19]Peura DA,Pilmer B,Hunt B,et al.Distinguishing the impact of dexlansoprazole on heart burn vs.regurgitation in patients with gastroesophageal reflux disease[J].Aliment Pharm Ther,2013,38(10):1303-1311.
[20]查倩倩,纽美娥,赵媛媛,等.胃食管反流病患者进行呼吸训练的研究进展[J].中华护理杂志,2018,53(10):1259-1263.
[2]El-Serag HB,Sweet S,Winchester CC,et al.Update on the epidemiology of gastroesophageal reflux disease:a systematic review[J].Gut,2014,63(6):871-880.
[3]中华医学会消化病学分会.2014年中国胃食管反流病专家共识意见[J].中华消化杂志,2014,34(10):649-661.
[4]Ozdil K,Kahraman R,Sahin A,et al.Bone density in proton pump inhibitors users:a prospective study[J].Rheumatol Int,2013,33(9):2255-2260.
[5]何海涛,丁西平,王金平,等.长期使用质子泵抑制剂对老年胃食管反流病患者肠道菌群的影响[J].山东医药,2018,58(18):47-50.
[6]Sun X,Shang W,Wang Z,et al.Short-term and long-term effect of diaphragm biofeedback training in gastroesopha-geal reflux disease:an open-label,pilot,randomized trial[J].Dis Esophagus,2016,29(7):829-836.
[7]Eherer AJ,Netolitzky F,H觟genauer C,et al.Positive effect of abdominal breathing exercise on gastroesophageal reflux disease:a randomized,controlled study[J].Am J Gastroenterol,2012,107(3):372-378.
[8]林三仁,许国铭,胡品津,等.中国胃食管反流病共识意见[J].中华内科杂志,2007,46(2):170-173.
[9]徐文红,林征,林琳,等.自我管理在门诊胃食管反流病患者中的应用及效果评价[J].中华护理杂志,2013,48(6):499-502.
[10]中国胃食管反流病研究协作组.反流性疾病问卷在胃食管反流病诊断中的价值[J].中华消化杂志,2003,23(11):651-654.
[11]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[12]刘贤臣,唐茂芹,胡蕾,等.匹兹堡睡眠质量指数的信度和效度研究[J].中华精神科杂志,1996,29(2):103-107.
[13]Mikami DJ,Murayama KM.Physiology and pathogenesis of gastroesophageal reflux disease[J].Surg Clin N Am,2015,95(3):515-525.
[14]Casale M,Sabatino L,Moffa A,et al.Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease(GERD):a systematic review[J].Eur Rev Med Pharmaco,2016,20(21):4547-4552.
[15]王苗,刘化侠,万学英,等.呼吸训练在非呼吸系统疾病中的应用现状及启示[J].中华护理杂志,2013,48(11):1030-1032.
[16]许婷,洪静芳,祝志慧.幸福疗法对肺癌患者术前焦虑抑郁症状群及主观幸福感的影响[J].广东医学,2017,38(2):325-328.
[17]Fujiwara Y,Arakawa T,Fass R.Gastroesophageal reflux disease and sleep disturbances[J].J Gastroenterol,2012,47(7):760-769.
[18]Niaz SK,Quraishy MS,Taj MA,et al.Guidelines on gastroesophageal reflux disease[J].J Pak Med Assoc,2015,65(5):532-541.
[19]Peura DA,Pilmer B,Hunt B,et al.Distinguishing the impact of dexlansoprazole on heart burn vs.regurgitation in patients with gastroesophageal reflux disease[J].Aliment Pharm Ther,2013,38(10):1303-1311.
[20]查倩倩,纽美娥,赵媛媛,等.胃食管反流病患者进行呼吸训练的研究进展[J].中华护理杂志,2018,53(10):1259-1263.