Study On The Pertinence Between Psychological/Emotional Factor And Chronic Gastritis

BackgroundChronic gastritis(CG) is a common frequently-occurring disease.The incidence rates is top of all gastropathy,and it is the most common di- seases of gastrointestinal disease.The cause of chronic gastritis and pathogenesis have not yet been fully clarified.Recently,Medical commu- nity generally agree that psychological/emotional fator is an important pathogenic factor of CG.About 50%patient who have emotional abnormalit- yes come about CG then,and gastrointestinal symptoms almost simultaneo- usly with emotional abnormalityes in the other 50%patients.Some patients with typical mental disorders.Tension,anxiety,emotional,irritable,angry,sad can cause vegetative nerve dysfunction,resulting in the occu- rrence of chronic gastritis or inducing chronic gastritis symptoms.Many study about psychological abnormalities in the performance of digestive diseases show that chronic gastritis in patients with abnormal psycholog- ical morbidity was significantly higher than the normal group.The modern medical research concluded that,stimulation of a variety of mental dysfunction may be caused the cerebral cortex dysfunction, stimulation of vagus nerve,causing the wall cells and G cells secreting a large number of gastric acid,may also lead to hyper secretion of adrenal cortical hormone to increase gastric acid and pepsin,as a result,the gastric mucosal occurs ulcers and superficial gastritis."brain-gut peptides" which double distributes in the gastrointestinal and nervous system's can also accommodate tthe digestive system from the central and peripheral.In traditional Chinese Medicine emotional upsets is a major cause of chronic gastritis. PurposeAnalyze the dot-dot pertinence between multiple psychological/emotional parameters and CG at the level disease,differentiated syndrome,as well as subtypes.Research the psychological characteristics of CG patients,the effect to this disease,and the signification of pathogenesis. MethodsBy means of chronic gastritis clinical questionnaireand,symptom checklist 90(SCL-90) and endoscopic observation;inner-sample contrast,apply to selected 200 CG patients syndrome differentiation of traditional Chinese medicine, endoscopic classification,genernal information quiz,symptom checklist 90 (SCL-90).Statistical analysis is processed on SPSS 17.0.X~2 test,T test and Pearson correlation are conducted.Results1.200 CG patients,male female ratio is 9:11.The average age is 36.8.most of 31 to 40 years old.The proportion is 42%,Higher than that of other age groups;The relationship between the CG morbidity and occupation.Unemployed or others in most(45.5%);The incident of spleen defiency and qi stagnation syndrome(80%),significantly higher than the other 3 syndromes;The incident of spleen defiency and qi stagnation syndrome of female patients(88.18%) is obviously higher than that of male(70%)(P<0.05);3.Investigation of symptom checklist 90(SCL-90):(1) The overall situation:Six factors of all CG patients is higher than those of standard model,such as: somatization(1.76±0.59),compulsion(1.66±0.6),depression(1.54±0.56), anxiety(1.51±0.54),terror(1.33±0.45),psychotic(1.36±0.48).By compareson with standard model,the somatization,anxiety and psychotic have statistic significance(P<0.05);(2)Sex:somatization(1.66±0.52)of male is obviously. Somatization(1.84±0.63),depression(1.63±0.54),anxiety(1.58±0.54),terror(1.39±0.47), psychotic(1.42±0.53)of female is obviously;(3) Age:the total(171.63±53.19),total average(1.91±0.59) and compulsion(2.21±0.76), interpersonal sensitivity(2.08±0.82),depression(2.18±0.86),terror(1.79±0.73),psychoticv(1.94±0.69) in 18-20 years group is higher than standard model.The psychotic have statistic significance(P<0.05),somatization is predominant respectively in 21-60 years group(P<0.05);(4)Level of education: Elementary patients have most obviously abnormal psychological symptoms.These patients have obviously,somatization,depression,anxiety,terror,psychotic (2.13±0.79,1.76±0.57,1.76±0.63,1.54±0.54,1.47±0.49,P<0.05).The result of Pearson correlation is the correlation between level of education and the total is negative.It shows that the patients with lower level of education have more serious alleosis;(5) Occupation:the total(169.71±25.88),total average(1.89±0.29) and all fator of the peasants patients is higher than standard model except interpersonal sensitivity,and most highest of all occupations.The somatization(2.44±0.68),compulsion(2.03±0.39), depression(1.87±0.35),anxiety(1.91±0.48) have statistic significance by compare.The somatization(1.86±0.65),anxiety(1.56±0.59) of u nemployed or others occupation patients are obvious(P<0.05).The somatization of selfemployed, workers,students patients are obvious(P<0.05).4.Among the four Chinese medicine differentiated syndromes,the total,total average and all fator score of spleen defiency and qi stagnation is highest. The total and total average of functional incoordination of the liver and stomach,spleen defiency and qi stagnation is higher than standard model. Somatization(1.7±0.53) and psychotic(1.31±0.36) are closely related to functional incoordination of the liver and stomach,and Somatization(1.77±0.6),anxiety(1.54±0.56) and terror(1.35±0.48) are closely related to spleen defiency and qi stagnation,compared with standard model.There is no relationship among other differtiated syndromes and psychological/emotional parameters.5.Among the 4 subtypes of western medicine,compared with standard model, somatization is closely related to erythema superficial gastritis(1.75±0.58,p<0.05),erosive gastritis(1.75±0.55,P<0.05),anxiety(1.52±0.54),terror(1.33±0.44),is closely related to erythema superficial gastritis, psychotic(1.41±0.48,P<0.05) is closed related to mucosal bleeding Hemorrhagic gastritis.No comparison done in atrophic gastritis,because of only case.ConclusionCompared with standard model,the CG Patients have alleosis to some extent, belong to psychosomatic disease.The heart related to stomach concept which Professor Fusheng Zhou advanced can serve as a convincible explanation of CG pathology;Compared all factors of SCL-90 in sex,age groups,levels of education,different occupation,the alleosis of female is more serious than that of male.The 18-20 age group or Elementary or peasants patients have severely obvious alleosis.The clinical syndrome of CG in centered on the spleen defiency and qi stagnation, of which the occurrence frequency is high,female especially.The distribution of differentiated syndromes is different by the occupa- tion.The proportion of functional incoordination of the liver and stomach,the spleen defiency and qi stagnation is largest;functional incoordination of the liver and stomach,the spleen defiency and qi stagnation both lead to higher tendency of psychological/emotional abnormity,the spleen defi- ency and qi stagnation especially,so this type syndrome is the difficult fator of CG. Relation between the level of alleosis and the subtype classification of gastritis:superficial gastritis erythema whit more symptoms of psychological disorder;The effective and efficient ereatment of CG may attach importance to psychological dredging,whose emphasis should be put on precaution of the tendency to somatization,anxiety and psychotic.