【摘要】：目的通過對山東省魯南地區(qū)消化性潰瘍患者的基本資料、生活飲食習慣、臨床特點等進行綜合研究,分析出該地區(qū)消化性潰瘍發(fā)病的主要相關(guān)因素,為該地區(qū)消化性潰瘍的臨床預防、診斷與治療提供參考。方法應用以醫(yī)院為基礎(chǔ)的病例-對照研究方法,根據(jù)統(tǒng)一的入組與排除標準,進行病例收集。隨機選取2012年1月~2013年6月滕州市中心人民醫(yī)院入院診治的確診為消化性潰瘍的患者318例、設(shè)為實驗組,并隨機選取同期滕州市中心人民醫(yī)院體檢的健康人群420例、設(shè)為對照組。對上述研究對象的基本資料、生活飲食習慣、口服藥物史、精神心理因素等進行問卷調(diào)查與指標分析。所有數(shù)據(jù)經(jīng)Epidata3.1建庫分析,并應用SPSS軟件行單因素、多因素分析。結(jié)果1、單因素分析1.1實驗組男性占該組72.96%(232人),女性占該組27.04%(86人),對照組男性占該組52.62%(221人)、女性占該組47.38%(199人),差異顯著(P0.05);實驗組體力勞動69.50%、腦力勞動30.50%,對照組分別為30.00%、70.00%,差異顯著(P0.05);實驗組潰瘍出血史88.05%、心腦血管病史79.56%、PU既往史88.36%、自身免疫疾病史1.89%,對照組分別為69.29%、54.76%、67.86%、0.95%,差異顯著(P0.05);實驗組Hp感染69.50%,對照組51.90%,差異顯著(P0.05);兩組年齡、學歷構(gòu)成具可比性,但無顯著差異(P0.05)。1.2實驗組吸煙64.47%、飲酒31.13%、生活規(guī)律61.01%、飲食規(guī)律55.97%,對照組吸煙53.10%、飲酒18.57%、生活規(guī)律21.67%、飲食規(guī)律72.14%,兩組差異顯著(P0.05);兩組睡眠時間具可比性,但無顯著差異(P0.05)。詳見表3。膳食調(diào)查中,實驗組與對照組差異顯著(P0.05)的有煎炸食品、熏烤腌制食品、辛辣食品、濃茶咖啡、牛奶。1.3實驗組SCL-90中9個因子的項目評分≥3的有焦慮(100.00%)、抑郁(100.00%)、人際關(guān)系敏感(80.00%)、強迫癥(50.00%)、敵對(40.00%),對照組分別為焦慮(30.00%)、人際關(guān)系敏感(30.00%),兩組差異顯著(P0.05);詳見表5。實驗組HAMA評分為2.58±1.17、HAMD評分為12.38±3.68,對照組分別為1.06±0.25、5.88±0.76,兩組差異顯著(P0.05)。1.4實驗組NSAIDs未服藥66.67%、短期服藥13.20%、長期服藥20.13%;對照組分別為90.47%、5.48%、4.05%,兩組差異顯著(P0.05)。2、多因素分析經(jīng)Logistic多因素回歸分析,影響PU發(fā)病的因素有心腦血管病史、Hp感染、吸煙、生活不規(guī)律、飲食不規(guī)律、辛辣食品、濃茶咖啡、牛奶、焦慮、抑郁、NSAIDs服藥史,其中牛奶為保護因素。結(jié)論1、影響魯南地區(qū)PU發(fā)病的相關(guān)因素有性別、職業(yè)、心腦血管病史、NSAIDs類等藥物、Hp感染、吸煙、飲酒、生活不規(guī)律、飲食不規(guī)律、煎炸食品、熏烤腌制食品、辛辣堅硬食品、濃茶咖啡、牛奶、焦慮抑郁等精神心理、NSAIDs服藥史,其中牛奶為保護因素。2、保持良好的生活習慣和方式,比如生活規(guī)律,戒除煙酒等不良嗜好、合理膳食,避免長期、大量進食辛辣腌制食品,減少煎餅等干硬食物,避免不合理使用NSAIDs類等藥物,均有利于魯南地區(qū)PU的預防和治療。
[Abstract]:Objective to analyze the main related factors of peptic ulcer in southern Shandong province through comprehensive study on the basic data, diet habits and clinical characteristics of peptic ulcer patients in this area. To provide reference for clinical prevention, diagnosis and treatment of peptic ulcer in this area. Methods Hospital-based case-control study was used to collect cases according to the standard of admission and exclusion. From January 2012 to June 2013, 318 patients with peptic ulcer were randomly selected from Teng Zhou Central people's Hospital as experimental group, and 420 healthy people who were examined in Tengzhou Central people's Hospital during the same period were randomly selected. Control group was set up. The basic data, diet habits, oral drug history, psycho-psychological factors and so on were investigated by questionnaire and index analysis. All the data were analyzed by Epidata3.1 and single factor and multi-factor analysis with SPSS software. Results 1. Univariate analysis 1.1 male accounted for 72.96% (232), female 27.04% (86), control group 52.62% (221), female 47.38% (199). The difference was significant (P0.05). In the experimental group, the physical labor was 69.50 and the mental work was 30.50. In the control group, the difference was significant (P0.05). The bleeding history of ulcer in the experimental group was 88.05, the history of cardiovascular and cerebrovascular diseases was 88.36, the history of autoimmune disease was 1.89, and the control group was 69.29 and 67.860.95, respectively. The difference was significant (P0.05). Hp infection was 69.50 in the experimental group and 51.90 in the control group (P0.05). There was no significant difference between the two groups in terms of age and educational background (P0.05). 1.2 the experimental group smoked 64.47, the drinking 31.13my, the living law 61.01a, the diet 55.97, the control group 53.100.The two groups had significant differences in age and academic background (P0.05). Drinking 18.57, living law 21.67, eating law 72.14, the difference between the two groups was significant (P0.05); The sleep time of the two groups was comparable, but there was no significant difference (P0.05). See table 3 for details. In the dietary survey, there were significant differences between the experimental group and the control group (P0.05): fried food, smoked and cured food, spicy food, strong tea coffee, Milk. 1.3 anxiety (100.00%), depression (100.00%), interpersonal sensitivity (80.00%), obsessive-compulsive disorder (50.00%), hostility (40.00%) were found in 9 factors of SCL-90 鈮，

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