摘要
目的:探讨便秘型肠易激综合征(irritable bowel syndrome with constipation,IBS-C)与功能性便秘(functional constipation,FC)患者精神心理临床特点的差异,进一步寻求精神心理因素在其发生发展的作用,为发展个体化治疗提供理论依据.方法:通过问卷调查分析IBS-C与FC患者的精神心理特点(包括抑郁、焦虑特征和生活质量评分).通过直观模拟标度尺(visual analogue scale/score,VAS)法和问卷来评估消化系症状进行结肠传输时间的测定和直肠肛门测压了解肠道生理功能情况.结果:208例长期便秘的患者,包括102例I B S-C患者和106例F C患者.在临床症状方面,IBS-C患者比FC患者在便秘、腹胀、腹痛和腹泻这些症状上更明显(P<0.05),但粪便性状和便秘症状评分两者差异无统计学意义(P>0.05);结肠传输时间测定,F C患者在直乙状结肠区域比IBS-C患者具有更高的传输,在其他区域传输时间两组者相似,而肛门直肠测压两者差异无统计学意义;IBS-C患者比FC患者在抑郁方面更明显(18.156±1.476 vs 11.902±1.351,P<0.01),高抑郁水平更多,但是两组中特质焦虑与状态焦虑、生活质量评分相似(P>0.05);多元线性回归分析表明症状程度和抑郁、焦虑评分仅在FC患者中呈正相关.结论:IBS-C与FC在精神心理方面存在着一定的差异,IBS-C比FC更抑郁,FC患者的抑郁、焦虑与症状程度存在相关性.我们结论支持针对便秘患者传统的治疗中融合社会心理的因素.此外,进一步的探讨了精神心理因素与特殊胃肠功能紊乱之间的病因关系,这将有利于发展个体化治疗的方法.
AIM： To explore the difference in psychological characteristics between patients with irritable bowel syndrome with constipation （IBS-C） and those with functional constipation （FC）, to seek the role of psychological factors in the pathogenesis of the two diseases, and to provide a theoretical basis for the development of individualized treatments for them.
METHODS： We retrospectively compared the psychological characteristics （depression, anxiety profiles and score for life quality） between patients with IBS-C vs those with FC using validated questionnaires. Subjects rated the intensity of digestive symptoms experienced using visual analogue scales and questionnaires. Colonic transit time measurements and anorectal manometry were performed.
RESULTS： Of the 208 consecutive constipated patients included, 102 suffered from IBS-C and 106 from FC. Demographic and physiological traits were similar between the two groups. Levels of the common symptoms such as constipation, bloating, abdominal pain and diarrhea in patients with IBS-C were higher than those in patients with FC （P 〈 0.05）, although there was no significant difference in Bristol stool form scale or constipation symptom score （P 〉 0.05）. Patients with FC had higher transit time in the recto-sigmoid area than IBS-C patients, although transit time in other regions was similar between the two groups. There was no significant difference in anorectal manometry measures between the two groups. Patients suffering from IBS-C reported significantly higher depression score （18.156 ± 1.476 vs 11.902 ± 1.351, P 〈 0.01）, and high depression scores were found more frequently in the IBS-C group as compared to the FC group, although trait anxiety and state anxiety were similar between the two groups （P 〉 0.05）. Multiple linear regression showed a positive correlation between symptom intensity and depression and anxiety scores only for FC patients.
CONCLUSION： IBS-C and FC have some differences in the psychological aspects. I
出处
《世界华人消化杂志》
CAS
北大核心
2014年第36期5615-5622,共8页
World Chinese Journal of Digestology
关键词
便秘型肠易激综合征
功能性便秘
抑郁
焦虑
Irritable bowel syndrome with constipation
Functional constipation
Depression
Anxiety
