The Evaluation Of The Mos 36-item Short Form Health Survey And Symptoms Questionnaire To GERD Grade Therapy

Gastroesophageal reflux disease(GERD) is a disease with nimiety content of stomach and duodenum reflux to the esophagus.The patients of GERD always have the damage of esophagus mucous and outside of the esophagus. The disease can be classified as reflux esophagitis (RE ) and endoscopy negative reflux disease, (NERD) .GERD is ordinary in the western country. GERD is a dynamical gastrointestinal disease which has relationship with acid. There are many kinds of reasons for its pathogeny. But the basic approach of its pathogeny is reflux contents' attack on the body with the weakly recovery . As we all known , acid is the most inportant attack factor. Though the reflux content is the direct factor to the esophagus mucous , the weakly recovery mechanism is the premise condition. The weakly recovery barrier of gastroesophageal junction , including lower esophageal sphinter pressure(LESP), transitlower esophageal sphinter relaxation(TLESR) > the limitation of anatomation structure, which lead to more Gastroesophageal reflux (GRE) affairs. The dropped clearance capability (including the volum clearanc and chemistry clearance) of esophagus makes the reflux content contact the esophagus longer time. And the resistance of esophageal mucosa is also dropped . It make the tissue easier to the harm. Furthurmore gastroesophageal reflux can also happende after these diseases: Diabetes mellitus, Primary Sjogren syndrome etc. What'more some operation,especially cardia resection, some medicine , life style (smoke ,drink ,unhealthy food) , can also weaken the recovery mechanism aggravate reflux.The most important therapy of GERD is to interdiction of the pathogenesis . And the therapy including ? acid control . It is the main measure to control the disease . The ordinary medicine is proton pump inhibitor (PPI) . (2) Protect the esophagus mucous (3) anti-reflux including medicine and operation .GERD is a kind of chronic , easy to recrudesce disease . The long-term therapy aggregate the economy burden. The most epidemiology data comes from developed countries . Our research's goal is to achieve the epidemiology data of Zhejiang province . And we also want to know the patients' therapy actuality and their life quality . What's more we will constitute the grade therapy project which based on PPIaccording to the patients' diseases .and appraise the evaluation of the Mos 36-item Short Form Health Survey and symptom survey to GERD . MethodsWe choose the patients from 11 hospitals of Zhejiang province . These patients are from plain moutain island and city . The time to cllect the patents is from 2004.9 to 2005.9 . The patients with representative symptom all receive gastroscopy . Those patients have RE under the gastroscopy are collected . We ask the patients some question about commonly instance , the characteris of the disease through questionnaire . We acquire the patients' symptom through symptom questionnaire. We know the patients' life quality through Mos 36-item Short Form Health Survey . Then we choose the appropriate patients to receive the grade therapy . The period of the treatment lasts for eighr weeks . After treatment , we evaluate the patients' curative effect .At last we evaluate integration appraisal of the SF-36 and symptom questionnaire to GERD grade therapy. Results -~. Commonly data analysis:We collect 261 patients . Male 210, 81% . Female 51 ,19% . The age of GERD is between 19-82 years .The average time of sicken is 16.8 monthes. Smoked 16% ,drunk 15% . —. Clinic character:1. Symptom appraise:(1) the appraise of symptom questionnaireThe score before treatment is 11.1 , Their symptom characters are heatrburn 78% , reflux 65% , acid of the mouth 48% , pain behind the breastbone 34%.(2) the symptom character outside of the esophagus Nause 58% , uncomfort of upper abdomen 47%, spew32% , eyewinker of pharynx 16% , chronic sound hoarse 10% , chronic cough 7% , ashma 1% .2. The appraise of SF-36The score of each dimensionality is descended. Especially the bod) pain and social function(52.62, 44.23). Vitality and general health > the scores of other dimensition are physical functioning:69.35. role-physical:70.45, role-emotional:60, mental health:63.69. H. Curative effect appraise1. Symptom questionnaire to appraise curative effectThe score was descended for 7.8 after therapy . Apparent effect 50 , availability 42 , impotence 21.The general availability rate of each grade are 72.7%,89%,70.6%75%. There is no apparent difference between each grade.We adopt Poisson regression to analysis the factors that influence the change of symptom survey .We find gender, smoke , and drink has no distinct influence on symptom survey . But age and the treatment projectby stages has distinct influence on symptom survey .2. SF-36 to appraise curative effect:The scores of each dimensionality before therapy are 68.5,50.4,57.4,58.8,57.7,43.3,41.7,63.9.After therapy they are: 84.7,79.4,82.7,56.7,54.8,48.9,83.4,68.5. Except vitality (VT) index has no distinct change , other indexes all show distinct change .3. Integrate appraisal:The symptom questionnaire and SF-36 has distinctive negative correlation with each other . ConclusionThe grade therapy project based on PPIs can improve the symptom and life quality of GERD patients . The Mos 36-item Short Form Health Survey and symptom questionnaire has a distinct coherence . They can be used as a perfect system to appraise GERD' grade therapy.