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中华胃食管反流病电子杂志

中华胃食管反流病电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 50 -55. doi: 10.3877/cma.j.issn.2095-8765.2023.01.010

护理园地

膈肌生物反馈训练对胃食管反流病的效果分析
闫晶, 蒋媛, 买买提·依斯热依力, 王俭, 王永康, 阿巴伯克力·乌斯曼, 王志, 克力木·阿不都热依木†()   
  1. 830001　乌鲁木齐，新疆维吾尔自治区人民医院腹腔镜、腹壁疝外科
    830001　乌鲁木齐，新疆维吾尔自治区人民医院腹腔镜、腹壁疝外科;830001　乌鲁木齐，新疆维吾尔自治区人民医院胃食管反流病及减重代谢外科临床研究中心
    830001　乌鲁木齐，新疆维吾尔自治区人民医院腹腔镜、腹壁疝外科;830001　乌鲁木齐，新疆维吾尔自治区人民医院胃食管反流病及减重代谢外科临床研究中心;830001　乌鲁木齐，新疆维吾尔自治区人民医院自治区普外微创研究所;830001　乌鲁木齐，新疆维吾尔自治区人民医院医学研究与转化中心
    830001　乌鲁木齐，新疆维吾尔自治区人民医院胃食管反流病及减重代谢外科临床研究中心;830001　乌鲁木齐，新疆维吾尔自治区人民医院自治区普外微创研究所
    830001　乌鲁木齐，新疆维吾尔自治区人民医院胃食管反流病及减重代谢外科临床研究中心
    830001　乌鲁木齐，新疆维吾尔自治区人民医院腹腔镜、腹壁疝外科;830001　乌鲁木齐，新疆维吾尔自治区人民医院胃食管反流病及减重代谢外科临床研究中心;830001　乌鲁木齐，新疆维吾尔自治区人民医院自治区普外微创研究所
  • 收稿日期:2022-11-19 出版日期:2023-02-15
  • 通信作者: 克力木·阿不都热依木
  • 基金资助:
    新疆维吾尔自治区人民医院院内项目(20200220)

Analysis the effect of diaphragm biofeedback training on patients with gastroesophageal reflux disease

Jing Yan, Yuan Jiang, Jian Wang, Yongkang Wang, Wusiman Ababokeli, Zhi Wang   

  1. Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
    Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Clinical research center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
    Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Clinical research center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Research Institute of General and Minimally Invasive Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Medical Research and Transformation Center of People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
    Clinical research center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Research Institute of General and Minimally Invasive Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
    Clinical research center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
    Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Clinical research center for Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China;Research Institute of General and Minimally Invasive Surgery, People's Hospital of Xinjiang Uygur Autonom ous Region, Urumqi 830001, China
  • Received:2022-11-19 Published:2023-02-15
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引用本文：

闫晶, 蒋媛, 买买提·依斯热依力, 王俭, 王永康, 阿巴伯克力·乌斯曼, 王志, 克力木·阿不都热依木. 膈肌生物反馈训练对胃食管反流病的效果分析[J]. 中华胃食管反流病电子杂志, 2023, 10(01): 50-55.

Jing Yan, Yuan Jiang, Jian Wang, Yongkang Wang, Wusiman Ababokeli, Zhi Wang. Analysis the effect of diaphragm biofeedback training on patients with gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2023, 10(01): 50-55.

目的

探讨膈肌生物反馈训练对胃食管反流病（GERD）患者改善症状及生活质量的治疗效果。

方法

选取2020年6月至2022年6月新疆维吾尔自治区人民医院腹腔镜、腹壁疝外科就诊收治的83例GERD患者，采用数字表法将其随机分为对照组（41例）和研究组（42例）；对照组患者给予临床常规药物及常规护理健康指导干预治疗，研究组患者在对照组治疗的基础上联合给予膈肌生物反馈训练和个性化护理干预治疗；2组均进行治疗8周。2组治疗前及治疗后收集GERD症状评分（GERDQ问卷）、生活质量测评（SF-36）、焦虑自评量表（SAS）、抑郁自评量表（SDS）以及匹茨堡睡眠质量指数量表（PSQI）等指标，对比分析2组患者改善症状和生活质量的效果，依据中国胃食管反流病专家共识意见的诊治标准对比评价2组的疗效。

结果

与治疗前相比，2组患者治疗后均显著改善GERD症状评分，SAS评分，SDS评分以及PSQI评分（P<0.05）；同时显著提高生活质量（SF-36评分；P<0.05）；而研究组改善上述指标的程度明显优于对照组，差异均有统计学意义（P<0.05）；提示膈肌生物反馈训练干预措施能够明显改善患者的GERD症状和抑郁焦虑睡眠障碍的发生，提高生活质量。与对照组相比，研究组的显效率和总有效率显著高于对照组，差异有统计学意义（P<0.05）。

结论

膈肌生物反馈训练及个性化护理干预治疗GERD治疗效果显著，值得进一步在临床推广应用。

关键词: 胃食管反流病, 膈肌生物反馈训练, 问卷调查, 症状, 生活质量
Objective

To investigate the effect of diaphragm biofeedback training on improving symptoms and quality of life in patients with gastroesophageal reflux disease (GERD).

Methods

From June 2020 to June 2022, 83 patients with GERD who were admitted to our hospital in laparoscopy and abdominal hernia surgery were selected and randomly divided into control group (n=41) and research group (n=42) according to different nursing interventions; The control group treated with ordinary therapy and routine nursing health guidance intervention, while the research group was given diaphragm biofeedback training and humanistic nursing intervention on the basis of routine drug treatment and health guidance in the control group; Both groups were treated for 8 weeks. GERD symptom score (GERDQ questionnaire), quality of life assessment (SF-36), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Pittsburgh sleep quality index (PSQI) were collected before and after treatment in the two groups, and the effects of the two groups on improving the symptoms and quality of life of GERD patients were compared and analyzed. The curative effect of the two groups were evaluated according to the diagnosis and treatment standards agreed by chinese experts on GERD.

Results

Compared with those before treatment, GERD symptom score, SAS score, SDS score and PSQI score were significantly decreased in both groups after treatment (P<0.05), and quality of life (SF-36 score) was significantly increased in both groups (P<0.05). Compare to control group, the improvement of the above indicators in the study group markedly significant (P<0.05); It is suggested that the diaphragm biofeedback training nursing intervention can significantly improve the GERD symptoms and improve the occurrence of depression, anxiety and sleep disorders. Compared with the control group, the apparent and total effective rates of the study group were significantly higher than those of the control group; The inefficiency was significantly lower than that of the control group (P<0.05).

Conclusion

Diaphragm biofeedback training and personalized nursing intervention have a significant effect on GERD, which is worthy of further clinical application.

Key words: gastroesophageal reflux disease, diaphragm biofeedback training, questionnaire, symptoms, quality of life
表1 2组患者临床基线资料比较（）
组别 例数 年龄（岁） 性别（男性/女性） BMI（kg/m2） 病程（年）
对照组 41 45.19±7.18 23/18 25.30±3.31 1.58±0.49
研究组 42 44.59±6.57 25/17 24.95±3.16 1.56±0.51
χ2/t值 0.397 0.100 0.489 0.157
P值 0.692 0.752 0.626 0.875
表2 2组患者各项观察指标评分比较（分，）
组别 例数 GERD评分 SF-36评分 SAS评分 SDS评分 PSQI评分
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
对照组 41 16.12±1.93 8.36±1.66* 68.34±7.18 82.39±6.46* 63.26±5.06 45.36±4.04* 61.41±3.70 46.36±3.98* 14.15±2.42 8.29±1.22*
研究组 42 15.80±2.21 7.35±1.22* 67.23±8.55 91.16±4.80* 61.67±5.24 36.09±3.70* 62.97±4.64 35.64±3.27* 15.07±2.45 5.71±1.02*
t值 0.686 3.142 0.635 -7.027 1.414 10.902 -1.691 13.406 -1.728 10.412
P值 0.495 0.002 0.527 <0.001 0.161 <0.001 0.095 <0.001 0.088 <0.001
表3 2组患者治疗效果比较[例（%）]
组别 例数 显效 有效 无效 总有效率
对照组 41 15（36.58） 22（53.66） 4（9.75） 37（90.24）
研究组 42 25（59.52） 16（38.09） 1（2.38） 41（97.62）
Z值 -2.236
P值 0.025
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