Bellyaching in These Pages: Upper Gastrointestinal Disorders in Psychosomatic Medicine
Bellyaching in These Pages: Upper Gastrointestinal Disorders in Psychosomatic Medicine
复制标题
这些页面中的腹痛：心身医学中的上胃肠道疾病
DOI：
10.1097/01.psy.0000024230.11538.c6
复制
发表时间：
2002
影响因子：
3.3
通讯作者：
S. Levenstein
中科院分区：
文献类型：
--
作者：
S. Levenstein
目的通过查阅自《心身医学》创刊以来发表的有关上消化道疾病的文章，追踪有关心理社会因素对消化性溃疡影响的观点演变。方法利用MEDLINE检索1939-2000年的题名，并通过手工检索目次。这些文章按类型分类，并按胃肠道主题、广泛的生物心理社会主题、方法论和假设进行综述。结果共检索到107篇论文，高峰出现在20世纪60年代。其中，73.8%是大样本研究，10.3%是病例报告或系列(1965年前)，15.9%是综述文章或评论(最常见的是1950年前和1990年后)。消化性溃疡占47.7%，溃疡相关占29.9%，非溃疡性消化不良或运动障碍占15.0%(1990年以来占主导地位)，其他占7.5%。1970年后，与消化性溃疡相关的原始调查稳步下降。人们一直关注心理因素与胃酸分泌的相互作用，但没有注意到与其他几个重要的溃疡危险因素的相互作用：幽门螺杆菌、吸烟和非类固醇抗炎药。随着时间的推移，对个性、压力和实验室方法论的兴趣保持稳定，而精神分析和特异性假说下降，心理评估的统计比较和量化方法上升。结论心身医学文献反映了消化性溃疡应激酸学说的历史：通过案例研究产生假说；实验研究的繁荣；当新的病因和有效的医学治疗方法出现时，退回到文献综述中，原始调查减少。
Objective The evolution of views regarding the impact of psychosocial factors on peptic ulcer was traced by examining all articles related to the upper gastrointestinal tract published in Psychosomatic Medicine since its inception. Methods Titles were retrieved using MEDLINE and by manually searching tables of contents for the years 1939 through 2000. The articles were classified by type and reviewed for gastrointestinal topic, broad biopsychosocial themes, methodology, and hypotheses. Results One hundred seven articles were found, peaking in the 1960s. Of these, 73.8% reported large-sample research, 10.3% were case reports or series (all before 1965), and 15.9% were review articles or commentaries (most frequent before 1950 and after 1990). The chief topic was peptic ulcer in 47.7%, ulcer related in 29.9%, nonulcer dyspepsia or motility in 15.0% (dominating research since 1990), and miscellaneous in 7.5%. Original investigations related to peptic ulcer dropped off steadily after 1970. Attention was consistently paid to interactions of psychological factors with gastric acid secretion but not with several other important ulcer risk factors:Helicobacter pylori, smoking, and nonsteroidal antiinflammatory drugs. Interest in personality, stress, and laboratory methodology remained steady over time, whereas psychoanalysis and the specificity hypothesis declined, and statistical comparisons and quantitative approaches to psychological assessment rose. Conclusions Psychosomatic Medicine articles reflect the life history of the stress-acid theory of peptic ulcer: hypothesis generation through case studies; a boom of experimental research; and retrenchment into literature reviews with a falloff in original investigations when new views of etiology and effective medical therapies appeared.