文章摘要
吴碧玉,陈胜良.老年人胃食管反流病伴精神心理障碍的识别与处理[J].中国临床保健杂志,2022,25(2):157-160.
老年人胃食管反流病伴精神心理障碍的识别与处理
Identification and management strategies of elderly GERD patients with psycho-social disorders
投稿时间:2021-11-09  
DOI:10.3969/J.issn.1672-6790.2022.02.004
中文关键词: 胃食管反流  精神障碍  身心疗法  整体保健  老年人
英文关键词: Gastroesophageal reflux  Mental disorders  Mind-body therapies  Holistic health  Aged 〖FL
基金项目:
作者单位E-mail
吴碧玉 上海交通大学医学院附属仁济医院消化科,上海消化疾病研究所,上海 200127 17wubiyu@sina.com,slchenmd@hotmail.com 
陈胜良 上海交通大学医学院附属仁济医院消化科,上海消化疾病研究所,上海 200127 slchenmd@hotmail.com 
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中文摘要:
      老年人群中的胃食管反流病(GERD)发病率逐年上升,已成为老年人群常见的消化系统疾病之一。老年人食管-胃连接处抗反流机制减弱、食管运动异常以及内脏高敏感是导致GERD发病的核心机制,这些机制均与精神心理及“肠脑”互动异常有关。早期识别和评估老年GERD患者是否伴有精神心理发病因素或合并精神心理异常表现的情况,将有助于改进治疗和慢病管理策略。临床医师在处理老年GERD时应该建立包含消化心身诊疗理念在内的整体医学观念,创建基于患者感受的良好医患沟通和信任关系。此外,合理地应用具有消化心身疾病专科特色的神经递质调节药物能够提升老年GERD患者的处置水平和临床疗效。
英文摘要:
      Gastroesophageal reflux disease (GERD) has become one of the most common gastrointestinal (GI) diseases in the elderly,with a rise in the incidence of GERD.Psychological factors and abnormal interaction of “brain-gut axis” are associated with the key pathogenesis of GERD in the elderly,including weakened anti-reflux barrier at gastro esophageal junction,abnormal esophageal motility and visceral hypersensitivity.Early identification and evaluation of psychological factors are vital to improve treatment and chronic disease management strategies for elderly GERD patients.Clinicians should establish an overall medical concept,which including the concept of psychosomatic digestive disorders and create a good relationship of physician-patient communication based on patients′ feelings when dealing with GERD in the elderly.In addition,the rational use of neurotransmitter regulating drugs characterized by digestive psychosomatic diseases can improve the disposal level and clinical efficacy for elderly GERD patients.
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