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肠易激综合征重叠功能性消化不良患者的临床症状、生存质量及精神心理状态分析

Clinical Features, Quality of Life and Psychological Health of Patients with Irritable Bowel Syndrome andFunctional Dyspepsia

  • 摘要: 目的 研究肠易激综合征(IBS)重叠功能性消化不良(FD)患者的临床症状、生存质量、焦虑抑郁状态及就医情况,为临床诊治提供依据。 方法 选取2012年9月至2013年5月就诊于四川大学华西医院消化门诊的IBS患者,根据是否重叠FD症状分为2组,选10名健康志愿者作为正常对照组。通过发放胃肠道症状评估量表(GSRS)、汉化版IBS-生存质量量表(ChIBS-QOL)以及汉密尔顿焦虑量表(HAMA)14项及汉密尔顿抑郁量表(HAMD)17项版本,比较所有受试者的临床症状、生存质量、焦虑抑郁状态及就医情况。 结果 60例IBS患者中25例(41.7%)重叠FD症状(IBS-FD)。IBS-FD患者的GSRS评分高于单纯IBS患者及健康志愿者,差异有统计学意义(P<0.05);IBS-FD患者就医次数多于单纯IBS患者,差异有统计学意义(P<0.05)。健康志愿者无焦虑及抑郁发生,单纯IBS患者多见轻度焦虑及抑郁,IBS-FD患者多见中-重度焦虑及抑郁;IBS-FD患者焦虑及抑郁发病率高于单纯IBS患者(分别为80.0%比51.4%,76.0%比48.6%),差异有统计学意义(P<0.05)。进一步分型提示重叠FD症状的便秘型IBS(IBS-C-FD)患者的GSRS评分最高、焦虑发病率最高及ChIBS-QOL评分最高。 结论 IBS-FD患者尤其IBS-C-FD患者较单纯IBS患者的胃肠道症状更严重、焦虑抑郁程度更重,生存质量更差。

     

    Abstract: Objective To investigate severity of gastrointestinal symptoms, quality of life, and mental health status of patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). Methods IBS patients were enrolled consecutively at the Outpatient Department of Gastroenterology, West China Hospital, Sichuan University from September 2012 to May 2013. The participants were divided into two groups according to their appearance with FD. Ten healthy volunteers served as normal controls. A questionnaire survey was undertaken to measure scores of gastrointestinal symptom rating scale (GSRS), Chinese IBS-quality of life (ChIBS-QOL), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and medical conditions. Results Twenty-five (41.7%) IBS patients were overlapped with FD (IBS-FD). The IBS-FD patients had significantly higher scores of GSRS than IBS patients and healthy volunteers (P<0.05). The IBS-FD patients saw doctors more frequently than IBS patients (P<0.05). Neither anxiety nor depression were observed in healthy volunteers. The IBS patients were more likely to present mild anxiety and depression, while the IBS-FD patients were more likely to present moderate to severe anxiety and depression. The IBS-FD patients had significantly higher prevalence of anxiety and depression than IBS patients (80.0% vs. 51.4%, 76.0% vs. 48.6% respectively, P<0.05). Scores of GSRS, ChIBS-QOL and prevalence of anxiety and depression were the highest in the IBS-FD patients with constipation (IBS-C-FD, P<0.05). Conclusion IBS-FD patients especially those with constipation suffer more gastrointestinal discomforts, and are more likely to suffer from anxiety and depression and poor quality of life compared with those with IBS only.

     

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