The relationship between stress and symptoms of gastroesophageal reflux: The influence of psychological factors
The relationship between stress and symptoms of gastroesophageal reflux: The influence of psychological factors
复制标题
DOI：
10.1097/00001610-199312000-00015
复制
发表时间：
1993-12
影响因子：
0.8
通讯作者：
N. Shields;L. Bradley;J. Richter;T. J. Pulliam;Julie M. Haile;I. Scarinci;Cathy A. Schan;C. Dalton;A. Salley
中科院分区：
文献类型：
--
作者：
N. Shields;L. Bradley;J. Richter;T. J. Pulliam;Julie M. Haile;I. Scarinci;Cathy A. Schan;C. Dalton;A. Salley
本文描述了压力、与慢性焦虑相关的心理特征、酸反流参数和对反流症状的感知之间关系的第一个对照研究。采用2（高与低胃肠道易感性评分）× 2（应激任务与中性任务）× 3（第1、2或3期）实验设计对17例有症状的反流性疾病受试者进行了研究。研究发现，压力任务显著增加了收缩压和舒张压、脉搏率以及焦虑和反流症状的主观评分。然而，应激任务不影响酸反流的客观参数（总酸暴露、反流发作次数、最长反流发作持续时间）。此外，应激对反流评分的影响主要是由于胃肠道易感性量表得分高的受试者的反应。这些受试者的反流评分在所有应激期都保持在高水平，而在所有其他实验条件下的受试者在各个时期都报告了反流症状的减少。这些结果表明，长期焦虑和长期应激的反流患者可能将低强度食管刺激视为疼痛的反流症状。未来的努力应致力于研究抗焦虑和行为疗法对这些反流患者的疗效。
This paper describes the first controlled study of the relationships among stress, psychological traits associated with chronic anxiety, acid reflux parameters, and perceptions of reflux symptoms. Seventeen subjects with symptomatic reflux disease were studied using a 2 (high vs. low gastrointestinal susceptibility score) x 2 (stress vs. neutral tasks) x 3 (periods 1, 2, or 3) experimental design. It was found that the stress tasks produced significant increases in systolic and diastolic blood pressure, pulse rates, and subjective ratings of anxiety and reflux symptoms. The stress tasks, however, did not influence objective parameters of acid reflux (total acid exposure, number of reflux episodes, duration of longest reflux episode). Moreover, the effect of stress on reflux ratings was due primarily to the responses of the subjects with high gastrointestinal susceptibility scale scores. These subjects' reflux ratings remained at high levels during all stress periods, whereas subjects in all other experimental conditions reported decreased reflux symptoms across periods. These results suggest that reflux patients who are chronically anxious and exposed to prolonged stress may perceive low intensity esophageal stimuli as painful reflux symptoms. Future effort should be devoted to examining the efficacy of anxiolytic and behavioral therapies with these reflux patients.