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目的：分析患者的食管测压结果、心理特征及小剂量阿米替林的干预效果。方法：选取2017年5月~2019年5月期间上海市静安区市北医院收治的癔球症患者137例（癔球症组），另选取同期到上海市静安区市北医院体检的健康志愿者50例（非癔球症组），比较两组食管测压结果、癔球症症状评分量表（GETS）评分、汉密尔顿抑郁量表-17（HAMD-17）评分、汉密尔顿焦虑量表-14（HAMA-14）评分。按随机数字表法将癔球症患者分为对照组（n=68）和研究组（n=69），对照组给予常规治疗，研究组则在对照组的基础上联合小剂量阿米替林干预。比较对照组、研究组的临床疗效、不良反应。结果：癔球症组、非癔球症组患者食管上括约肌（UES）长度、UES残余压、食管下括约肌（LES）静息压、收缩前沿速度（CFV）、远端潜伏时间（DL）组间比较差异无统计学意义（P>0.05）；癔球症组患者UES静息压高于非癔球症组（P<0.05）。癔球症组患者GETS、HAMA-14、HAMD-17评分高于非癔球症组（P<0.05）。研究组治疗后的临床总有效率为84.06%（58/69），高于对照组的66.18%（45/68）（P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论：相对于非癔球症患者，癔球症患者具有较高的UES静息压，癔球症症状及较为严重的不良情绪，采用小剂量阿米替林对癔球症进行干预可提高治疗有效率，用药安全性较好。

英文摘要:

Objective: To analysis the esophageal manometry results, psychological characteristics and intervention effect of low dose amitriptyline in patients with globus. Methods: 137 patients with globus who were admitted to Shibei Hospital of Shanghai Jing''an District from May 2017 to may 2019 (globus group). Another 50 healthy volunteers (non globus group) who came to Shibei Hospital of Shanghai Jing''an District for physical examination at the same time were selected. The results of esophageal manometer, Globus sensation symptom scale (GETS), Hamilton depression scale -17 (HAMD-17) and Hamilton anxiety scale -14 (HAMA-14) were compared between the two groups. Patients with globus were divided into control group (n=68) and study group (n=69) according to the random number table method. The control group was given routine treatment, while the study group was combined with low-dose amitriptyline intervention on the basis of the control group. The clinical efficacy and adverse reactions of the control group and study group were compared. Results: There were no significant differences in the length of the upper esophageal sphincter (UES), the residual pressure of ues, the rest pressure of the lower esophageal sphincter (LES), the pre systolic velocity (CFV) and the distal latency time (DL) between the globus group and the non globus group (P>0.05). The resting pressure of ues in globus group was higher than that in non globus group (P<0.05). The scores of GETS, HAMA-14 and HAMD-17 in globus group were higher than those in non globus group (P<0.05). The total clinical effective rate of the study group was 84.06% (58/69), which was higher than 66.18% (45/68) of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with non globus patients, globus patients have higher ues resting pressure, globus symptoms and more serious adverse emotions. Low dose amitriptyline intervention can improve the treatment efficiency, and it has drug safety.

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