切换至 "中华医学电子期刊资源库"

中华诊断学电子杂志 ›› 2020, Vol. 08 ›› Issue (02) : 130 -134. doi: 10.3877/cma.j.issn.2095-655X.2020.02.014

所属专题: 专题评论 文献

临床研究

癔球症患者临床精神心理学特征及少商穴经皮电刺激治疗的疗效评价
何梓健1, 贾林2,(), 邓祺1, 赵寒冰3, 孟默2, 郭婉薇4   
  1. 1. 510180 广州医科大学附属市一人民医院消化内科
    2. 510180 广州市第一人民医院消化内科
    3. 550025 贵阳,贵州医科大学附属医院消化内科
    4. 510180 广州,广东省第二人民医院消化内科
  • 收稿日期:2020-02-26 出版日期:2020-05-26
  • 通信作者: 贾林

Clinical psychopsychological characteristics of globus pharyngeus and evaluation of the therapeutic effect of transcutaneous electrical acupoint stimulation at Shaoshang acupoint

Zijian He1, Lin Jia2,(), Qi Deng1, Hanbing Zhao3, Mo Meng2, Wanwei Guo4   

  1. 1. Department of Gastroenterology, the First People′s Hospital Affiliated to Guangzhou Medical University, Guangzhou 510180, China
    2. Department of Gastroenterology, Guangzhou First People′s Hospital, Guangzhou 510180, China
    3. Department of Gastroenterology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550025, China
    4. Department of Gastroenterology, Guangdong Second Provincial General Hospital, Guangzhou 510180, China
  • Received:2020-02-26 Published:2020-05-26
  • Corresponding author: Lin Jia
  • About author:
    Corresponding author: Jia Lin, Email:
引用本文:

何梓健, 贾林, 邓祺, 赵寒冰, 孟默, 郭婉薇. 癔球症患者临床精神心理学特征及少商穴经皮电刺激治疗的疗效评价[J]. 中华诊断学电子杂志, 2020, 08(02): 130-134.

Zijian He, Lin Jia, Qi Deng, Hanbing Zhao, Mo Meng, Wanwei Guo. Clinical psychopsychological characteristics of globus pharyngeus and evaluation of the therapeutic effect of transcutaneous electrical acupoint stimulation at Shaoshang acupoint[J]. Chinese Journal of Diagnostics(Electronic Edition), 2020, 08(02): 130-134.

目的

探讨癔球症患者临床精神心理学特征和经皮穴位电刺激(TEAS)少商穴治疗癔球症的疗效。

方法

选取2017年9月至2019年6月于广州市第一人民医院南沙医院、广东省第二人民医院、贵州医科大学附属医院耳鼻喉科及消化内科门诊就诊的60例癔球症患者,按随机数字表法分为对照组(n=30)和少商穴组(n=30),采用适宜强度的电流刺激少商穴组患者,每天2次,每次30 min;采用适宜强度的电流刺激对照组患者少商穴位旁1~2 cm的非经络体表位置,每天2次,每次30 min,疗程均为4周。采用癔球症症状评分(GETS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及匹兹堡睡眠质量指数(PSQI)对患者进行治疗前和治疗4周后的疗效评估。

结果

60例癔球症患者中,发现60.00%(36/60)的患者伴发睡眠障碍,65.00%(39/60)的患者伴发焦虑,35.00%(21/60)的患者伴发抑郁。经4周治疗后,对照组GETS、PSQI、HAMA、HAMD评分[(16.37±4.94)分,(12.37±7.51)分,(9.80±6.19)分,(10.67±7.63)分]与治疗前[(20.50±5.26)分,(14.53±6.80)分,(12.63±6.53)分,(12.60±8.43)分]比较,均差异有统计学意义(t=3.98,3.28,4.59,2.28;均P<0.05);少商穴组治疗后GETS、PSQI、HAMA、HAMD评分[(12.43±3.79)分,(8.50±6.76)分,(9.07±6.52)分,(8.47±6.72)分]与治疗前比较[(22.27±5.16)分,(13.43±7.30)分,(15.33±6.51)分,(13.97±4.99)分],均差异有统计学意义(t=8.44,6.93,7.49,5.77;均P<0.05);少商穴组各评分的下降程度ΔGETS、ΔPSQI、ΔHAMA、ΔHAMD[(6.49±6.38)分、(3.44±3.85)分、(4.60±4.59)分、(3.47±5.22)分]大于对照组[(2.93±4.04)分,(2.17±3.62)分,(2.83±3.38)分,(1.93±4.11)分],均差异有统计学意义(t=5.04,2.80,3.30,2.94;均P<0.05)。同时,少商穴组较对照组GETS评分[66.67%(20/30),20.00%(6/30)]、PSQI评分[63.33%(19/30),23.33%(7/30)]、HAMA评分[66.67%(20/30),30.00%(9/30)]、HAMD评分[60.00%(18/30),26.67%(8/30)]治疗的有效率高,均差异有统计学意义(χ2=13.30,9.77,7.28,6.79;均P<0.05)。

结论

癔球症患者多伴有睡眠障碍、焦虑状态和抑郁状态,少商穴TEAS治疗可有效改善癔球症患者的症状、睡眠障碍、焦虑和抑郁状态。

Objective

To investigate the clinical psychopsychological characteristics of patients with globus pharyngeus and the therapeutic effect of transcutaneous electrical acupoint stimulation(TEAS)at Shaoshang acupoint.

Methods

A total of 60 patients from September 2017 to June 2019 in the Otolaryngology and Gastroenterology Department of the Nansha Hospital of Guangzhou First People′s Hospital, the Guangdong Second Provincial General Hospital and the Affiliated Hospital of Guizhou Medical University were selected. The random number table method was used to divide the patients into control group (n=30) and Shaoshang acupoint group (n=30). With the treatment for 4 weeks, Shaoshang acupoint group was asked to stimulate Shaoshang acupoint with the current of appropriate strength, twice a day, 30 min each time, while control group was asked to stimulate non-meridian body surface position of 1-2 cm off the Shaoshang acupoint. The scores of Glasgow Edinburgh throat scale(GETS), Hamilton anxiety scale(HAMA), Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI) were evaluated before and after 4 weeks treatment.

Results

Among the 60 patients with globus pharyngeus, 60.00% (36/60) were found to have sleep disorders, 65.00% (39/60) with anxiety, and 35.00% (21/60) with depression. After treatment, the scores of GETS, PSQI, HAMA and HAMD in the control group [(16.37±4.94), (12.37±7.51), (9.80±6.19), (10.67±7.63)] were compared with those before treatment [(20.50±5.26), (14.53±6.80), (12.63±6.53), (12.60±8.43)], the differences were statistically significant (t=3.98, 3.28, 4.59, 2.28, all P<0.05). The scores of GETS, PSQI, HAMA and HAMD 4 weeks after treatment of Shaoshang acupoint group [(12.43±3.79), (8.50±6.76), (9.07±6.52), (8.47±6.72)] were compared with those before treatment [(22.27±5.16), (13.43±7.30), (15.33±6.51), (13.97±4.99)], the differences were statistically significant (t=8.44, 6.93, 7.49, 5.77, all P<0.05). The decreased scores of GETS, PSQI, HAMA and HAMD in the Shaoshang acupoint group before and after treatment [(6.49±6.38), (3.44±3.85), (4.60±4.59), (3.47±5.22)] were greater than those in the control group [(2.93±4.04), (2.17±3.62), (2.83±3.38), (1.93±4.11)], and the differences were statistically significant (t=5.04, 2.80, 3.30, 2.94, all P<0.05). Meanwhile, the effective rates of treatment in Shaoshang acupoint group on GETS score [66.67%(20/30), 20.00%(6/30)], PSQI score [63.33%(19/30), 23.33%(7/30)], HAMA score [66.67%(20/30), 30.00%(9/30)], and HAMD score [60.00%(18/30), 26.67%(8/30)] were significantly higher than those of the control group, with statistically significant differences (χ2=13.30, 9.77, 7.28, 6.79, all P<0.05).

Conclusions

Globus pharyngeus are often accompanied with sleep disorders, anxiety and depression. Shaoshang acupoint treated by TEAS can effectively improve the symptoms, sleep disorders, anxiety and depression of globus pharyngeus.

表1 两组癔球症患者治疗前后各评分比较(分,±s)
表2 两组患者治疗前后评分差值比较(分,±s)
表3 两组癔球症患者治疗有效率比较(例,%)
[1]
Tang B, Cai HD, Xie HL,et al.Epidemiology of globus symptoms and associated psychological factors in China[J].J Dig Dis,2016,17(5):319-324.
[2]
Liu S, Peng S, Hou X, et al. Transcutaneous electroacupuncture improves dyspeptic symptoms and increases high frequency heart rate variability in patients with functional dyspepsia[J].Neurogastroenterol Motil,2008,20(11):1204-1211.
[3]
Zhang N, Song G, Chen J,et al.Ameliorating effects and autonomic mechanisms of needle-less transcutaneous electrical stimulation at ST36 on stress-induced impairment in gastric slow waves[J].J Gastroenterol Hepatol,2015,30(11):1574-1581.
[4]
Meng LN, Chen S, Chen JD,et al.Effects of Transcutaneous electrical acustimulation on refractory gastroesophageal reflux disease.[J].Evid Based Complement Alternat Med,2016(2016):8246171.
[5]
雷晓改,贾林,许鸣,等.难治性功能性消化不良患者的饮食行为研究[J].中华行为医学与脑科学杂志,2013,22(3):208-211.
[6]
Deary IJ, Wilson JA, Harris MB,et al.Globus pharyngis:development of a symptom assessment scale[J].Psychosom Res,1995,39(2):203-213.
[7]
Buysse DJ, Reynolds CF, Monk TH, et al.The pittsburgh sleep quality index: a new instrument for psychiatric practice and research[J].Psychiatry Res,1989,28(2):193-213.
[8]
Matza LS, Morlock R, Sexton C,et al.Identifying HAM-A cutoffs for mild,moderate,and severe generalized anxiety disorder[J]. Int J Methods Psychiatr Res,2010,19(4):223-232.
[9]
Calotǎ DR, Nitescu C, Marinescu S,et al.Correlations between morphological appearance and psychosocial difficulties in patients with extensive burns who received allotransplant[J].Rom J Morphol Embryol,2012,53(3 Suppl):703-711.
[10]
徐艳,王晓瑜.氟哌噻吨美利曲辛片辅助治疗难治性非糜烂性胃食管反流病的临床观察[J].临床消化病杂志,2016,28(6):367-369.
[11]
Lee BE, Kim GH.Globus pharyngeus:a review of its etiology,diagnosis and treatment[J].World J Gastroenterol,2012,18(20):2462-2471.
[12]
唐贝,贾林,蔡厚达,等.广州地区人群癔球症的发病学特征及城乡差异[J].中华行为医学与脑科学杂志,2016,25(6):537-541.
[13]
陈冬云,贾林.癔球症患者食管上括约肌压力分型及其严重程度的影响因素[J/CD].中华诊断学电子杂志,2016,4(3):153-156.
[14]
Tokashiki R, Yamaguchi H, Nakamura Kazuhiro, et al. Globus sensation caused by gastroesophageal reflux disease.[J]. Auris Nasus Larynx,2002,29(4):347-351.
[15]
Chen DY, Jia L, Gu X,et al.Comparison of paroxetine and amitriptyline in the treatment of refractory globus pharyngeus[J].Dig Liver Dis,2016,48(9):1012-1017.
[16]
Deary IJ, Wilson JA, Kelly SW.Globus pharyngis,personality,and psychological distress in the general population[J].Psychosomatics,1995,36(6):570-577.
[17]
王乔,章礼久.癔球症患者精神心理状态分析[J].山东医药,2013,53(39):68-69.
[18]
Jia L, Jiang SM, Liu J. Behavioral gastroenterology: an emerging system and new frontier of action[J]. World J Gastroenterol,2017,23(33):6059-6064.
[19]
刘慧华,王颖敏,何晓阔,等.单次电针与经皮穴位电刺激治疗前后体感诱发电位的比较[J].中国康复理论与实践,2017,23(2):185-188.
[1] 赵宏, 崔红, 宋雪杨, 曾敏敏. 儿童牙科畏惧症的影响因素及其与父母教养方式的相关性研究[J]. 中华口腔医学研究杂志(电子版), 2023, 17(02): 111-117.
[2] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[3] 王琦, 陈新, 闵捷, 方露, 刘志奇, 孙伟, 于德新. 膀胱软镜镜检术中改良"Bag Squeeze"法的应用与疼痛焦虑影响因素分析[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 237-241.
[4] 戴玮, 江桂林, 车兆平, 张姣, 王星星, 赵海涛. 无缝手术护理在腹股沟疝腹腔镜手术围手术期的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 778-781.
[5] 张荷连, 刘禹, 李丹妮, 彭茹, 杨彩蝶, 窦恒, 吴红梅. 心理障碍对重度哮喘患者的疾病控制及生活工作质量的影响[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 589-591.
[6] 蒋丽, 王晓慧, 李维益, 苟双芸, 丁敏, 杨丽. 创新智能健康教育与随访管理对肺结节患者焦虑的影响随机对照研究[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 485-489.
[7] 赵晓红, 修翠萍, 张瑜, 吴珂. 大康复理念在COPD稳定期肺康复治疗的临床应用[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 424-426.
[8] 王小蓓, 秦雯, 符天选, 谭春苗. AECOPD睡眠障碍对肺功能炎性因子及焦虑抑郁状态的影响[J]. 中华肺部疾病杂志(电子版), 2023, 16(02): 260-262.
[9] 付强, 秦丽媛, 李全波. 神经病理性疼痛患者血清miR-15a水平及意义分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 293-298.
[10] 潘惠, 王明, 杨忠, 杜向东. 低频重复经颅磁刺激辅助治疗伴不同特征抑郁症的对照研究[J]. 中华临床医师杂志(电子版), 2023, 17(05): 562-568.
[11] 黄涌, 邓宏平, 黄丽, 沈秋桐, 曹汉忠. 耳穴压籽联合经皮穴位电刺激对老年膝关节置换术后急性疼痛的作用[J]. 中华临床医师杂志(电子版), 2023, 17(03): 285-290.
[12] 郭梦, 雷蕾, 杨春霞, 孙宁, 张爱霞, 张克让. 抑郁症患者静息态脑电功能连接的研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(02): 210-214.
[13] 李琼蔚, 苏怡, 卢喆, 李谦, 孙伟. 内蒙古赤峰地区高中生睡眠问题现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(02): 117-124.
[14] 文明, 熊英, 艾克拜尔·艾力, 克力木·阿不都热依木. 质子泵抑制剂治疗期间焦虑对胃食管反流病疗效的影响[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 90-95.
[15] 张佳玉, 丁玉兰, 郑旋玲, 刘长勤. 睡眠障碍对多囊卵巢综合征不良影响的研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(02): 131-136.
阅读次数
全文


摘要