The Study Of The Relation Between Distribution Of Chinese Medical Patterns In Gastroesophageal Reflux Disease And Mental State

ObjectiveThis study analyses the mental states of different Chinese medical patterns in gastroesophageal reflux disease(GERD)through combining the method of distribution of Chinese medical patterns and mental-related scales.And to discuss the possible correlation between Chinese medical patterns in GERD and depressed or anxious psychology in order to understand the influence of mental factor in the progress of GERD.So provide the theoretical evidence for the clinical therapy,and for better guidance to the herbal prescription.MethodsThis is a cross-sectional study,collecting the information of Selfmade Questionnaire State-Trait Anxiety Inventory(STAI),Hospital Anxiety and Depression Scale(HADS)and Patient Health Questionnaire-15(PHQ-15)from GERD patients in outpatient.The collected data was analysed by SPSS 19.0 software.The distribution of Chinese medical patterns in GERD and correlation between Chinese medical patterns in GERD and mental factor were discussed.ResultsTotally received 104 survey scales,96 available.Among the available data,there were 53 males and 43 females.Age ranged from 24 to 67 and average age was 48.66±11.73.63 were Non-Erosive Reflux Disease(NERD),27 were Reflux Esophagitis(RE),6 were Barrett's Esophagus(BE).14 wre Insufficiency of Qi with Qi Reversal Pattern(IQQRP),36 were Qi Depression Phlegm Obstruction Pattern(QDPOP),16 were Stagnation-Heat in Liver and Stomach Pattern(SHLSP),22 were Gallbladder Heat Invade Stomach Pattern(GHISP),8 were Blood Stasis Vessel Obstruction Pattern(BSVOP).The distribution of syndromes of Chinese medicine were: 60 sour regurgitation cases,58 heartburn cases,68 belching cases,4 vomiting cases,30 nausea case,62 gastric pain cases,18 advanced gastric pain by mood cases,66 gastric distention cases,44 abdominal distention cases,38 abdominal pain cases,10 advanced abdominal pain by mood cases,32 foreign body sensation cases,28 cases with bitter taste,54 with thirsty,38 were irritability,10 hectic fever cases,44 with fatigue,42 aversion to cold cases,30 with a cumbersome body,28 with discomfort stomach,32 with poor appetite.The top 5 syndromes of Chinese medicine were: sour regurgitation,heartburn,belching,gastric pain and gastric distention.There were no statistically different among the 5 patterns in S-AI ? STAI and HAD-A(P > 0.05),while the results were opposite in T-AI ? HAD-D and HADS(P < 0.05).By further analaysing the difference in T-AI ? HAD-D and HADS,we found that both BSVOP`s and SHLSP`s T-AI average scores overtopped IQQRP`s and QDPOP`s(P<0.05).The same result occurred in HAD-D along with GHISP(P<0.05).In HADS scores,only BSVOP still kept the lead(P < 0.05).In the assessment of somatization symptom in different patterns,BSVOP`s symptom were more serious than any other patterns,but no connection could be found between the Chinese medical patterns and somatization symptom.ConclusionThis research preliminary revealed that liver-stomach disharmony was the one of the most common pattern in the distribution Chinese medical patterns in GERD,precisely QDPOP,SHLSP and GHISP were dominant.IQQRP and QDPOP was the basic pathogenesis in GERD,which mainly occurs at the early stage of the progress,in this stage,the mental disorder of the patients were relatively light.However,with the progress of GERD going on,QDPOP could turned into SHLSP or GHISP,which caused more severe mental disorder and somatization symptom,when ultimately turned into BSVOP,as the final state of the disease,the worst mental disorder and somatization symptom occurred.We found that there was no correlation between Chinese medical patterns and somatization symptom.