Study on the Correlation Between Gastric Motility,Psychosocial Factors and Gastroesophageal Reflux Disease in the Elderly
Objective To investigate the role of gastric motility and psychosocial factors in the development of gastroesophageal reflux disease(GERD)in the elderly.Methods A total of 180 patients who met the diagnostic criteria for GERD admitted to Fujian Provingcial Geriatric Hospital from January 2020 to December 2022 were selected and included.The participants were divided into the elderly group(n=96)and the non-elderly group(n=84)according to the age≥60 years.reflux disease questionnaire(RDQ),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)scores and gastric electrogastrography were compared between the elderly group and the non-elderly group.In the elderly group,patients with comorbid anxiety or depression were randomLy assigned to four treatment groups:conventional PPI monotherapy,PPI+Itopride,PPI+Flupentixol and Melitracen,and PPI+Itopride+Flupentixol and Melitracen.Gastric electrogastrography,levels of gastrointestinal hormones(motilin and leptin),HAMD scores,and HAMA scores,as well as RDQ scores were compared before and after treatment.Results The average frequency and amplitude of gastric electrogastrogram waves in the non-elderly group were(2.51±0.46)cpm and(173.27±32.76)μV respectively,with HAMD and HAMA scores of(6.75±2.90)and(7.22±2.90)respectively,and an RDQ scores of(19.25±4.29).The average frequency,amplitude,HAMD,HAMA score,and RDQ scores of the gastric electrogram waveform in the elderly group were(1.76±0.35)cpm,(60.81±24.40)μ V,(14.97±6.83)points,(12.48±6.65)points,and(18.92±3.94)points,respectively,there was no significant difference in RDQ scores between the elderly group and the non-elderly group(P>0.05).However,the elderly group had higher HAMD and HAMA scores and lower gastric motility compared to the non-elderly group.In the elderly group,patients with comorbid anxiety or depression showed improvement in gastric motility,levels of gastrointestinal hormones,HAMD or HAMA scores,and RDQ scores after treatment(P<0.05).Both the PPI+Itopride group and the PPI+Flupentixol and Melitracen group showed significant improvement compared to the PPI monotherapy group.Among the four treatment groups,the PPI+Itopride+Flupentixol and Melitracen group showed the most pronounced improvement(P<0.05).Conclusion Besides acid exposure,gastric motility and psychosocial factors may play important roles in the development of GERD.
万方数据
维普
