胃食管反流病合并情绪障碍的研究现状与诊治策略

唐艳萍; 李培彩

doi:10.3969/j.issn.1671-038X.2023.07.03

胃食管反流病合并情绪障碍的研究现状与诊治策略

唐艳萍^1, ,,
李培彩¹

- 天津市南开医院脾胃病中心(天津，300100)
基金项目:
国家自然科学基金资助项目(No：82074213，No：82274253，No：82204988)；天津市中医药管理局资助项目(No：2021045)

详细信息

作者简介:
唐艳萍，主任医师，硕士研究生导师，现任天津市南开医院脾胃病中心主任。兼任中国中医药促进会消化整合学会副会长、中国民族医药学会消化分会副会长、中国医疗保健国际交流促进会胃食管反流病学分会副主委、中国中西医结合学会消化系统疾病专委会秘书长兼首届胃食管反流病专家委员会主委、中国中西医结合学会消化内镜学专委会常委兼消化心身专家委员会主委、中华中医药学会脾胃病分会常委、中华医学会心身分会常委兼消化学组副组长、天津市医疗健康学会消化专委会主委等。担任《中国中西医结合消化杂志》副主编，Journal of Clinical and Basic Psychosomatics编委，Gut Microbiota and Integrative Wellness编委，《中华医学信息导报》编委。主持国家自然科学基金课题4项，省部级以上课题8项，获中华中医药学会科学技术一等奖1项、中国中西医结合学会科学技术二、三等奖各1项、天津市科技进步三等奖1项、国家级及天津市科学技术成果奖10余项。主编医学专著3部，其中主编的专著《消化系统西医难治病种中西医结合诊疗方略》获中华中医药学会学术著作一等奖，公开发表论文170篇。主笔中国中西医结合学会2022年团体标准《胃食管反流病中西医结合专家诊疗共识意见》

通讯作者: 唐艳萍，E-mail：cb1699@sina.com

中图分类号: R473.5

收稿日期: 2023-04-15

刊出日期: 2023-07-15

Research status and diagnosis and treatment strategies of gastroesophageal reflux disease with emotional disorders

TANG Yanping^1, ,,
LI Peicai¹

- Gastroenterology Center, Tianjin Nankai Hospital, Tianjin, 300100, China

More Information

Corresponding author: TANG Yanping, E-mail: cb1699@sina.com

Received Date: 15 April 2023

Publish Date: 15 July 2023

摘要

摘要: 胃食管反流病(gastroesophageal reflux disease，GERD)是临床常见的消化系统疾病，机制复杂，情绪障碍在GERD的发生、发展及转归中起到了重要作用，其相互影响的可能机制为：应激导致的脑肠互动异常；情绪障碍可引起某些促炎因子释放及5-HT信号通路紊乱，加重食管免疫炎症及动力异常；迷走神经功能紊乱；食管内脏高敏感；食管及肠道菌群异常。情绪障碍可促进GERD与功能性胃肠病症状重叠，影响GERD药物及抗反流手术的治疗效果。其治疗策略包括：建立互信的医患关系、进行必要的心理干预，重症难治者可使用神经递质药。另外，中医药通过辨证论治，对于治疗该类患者显示出明显优势，未来建立GERD中西医结合防治体系意义重大。
- 胃食管反流病 /
- 情绪障碍 /
- 心理应激 /
- 食管 /
- 肠道菌群 /
- 食管内脏高敏感
Abstract: Gastroesophageal reflux disease(GERD) is a common digestive system disease in clinical practice, with complex mechanisms. Studies have shown that emotional disorders may play a vital role in the occurrence, development, and prognosis of GERD. Several evidence have shown the possible mutual mechanisms, which involve the abnormal brain gut interaction caused by stress, the release of certain pro-inflammatory factors and disruption of the 5-HT signaling pathway caused by emotional disorders, exacerbating esophageal immune inflammation and abnormal motility, the vagal nerve dysfunction, the esophageal visceral hypersensitivity, and the abnormal esophageal and intestinal microbiota. Emotional disorders can promote the overlap of GERD and functional gastrointestinal disease symptoms, affecting the therapeutic effect of GERD drugs and anti-reflux surgery. The treatment strategies include establishing a mutual trust doctor-patient relationship, providing necessary psychological intervention, and using neurotransmitter drugs for severe and difficult-to-treat patients. In addition, Traditional Chinese Medicine has shown significant advantages in treating such patients through syndrome differentiation and treatment. It is of great significance to establish a comprehensive prevention and treatment system of Traditional Chinese and Western Medicine in the future.
- gastroesophageal reflux disease /
- emotional disorders /
- psychological stress /
- esophageal /
- intestinal microbiota /
- esophageal visceral hypersensitivity

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