摘要
目的调查分析腹泻型肠易激综合征（IBS-D）患者合并焦虑、抑郁对生命质量的影响及性别差异。方法连续纳入符合罗马Ⅲ诊断和分型标准的IBS-D患者，以面对面方式问卷调查患者胃肠道症状，完成IBS生命质量量表（IBS-Q（）L），进行汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）测评。统计学方法采用卡方检验、方差分析、t检验或Speaman秩相关分析。结果共纳入155例IBS-D患者，其中115例患者合并焦虑和（或）抑郁，男性和女性合并心理异常分别占71．13％（69／97）和79．31％（46／58），差异无统计学意义（χ^2=1．267，P=0．260）。相比40例无焦虑抑郁患者，59例单纯合并焦虑、56例合并焦虑和抑郁或抑郁患者，其肠道症状计分分别为20．85±5．84、21．71±7．47、22．87±6．09，差异无统计学意义（F=1．143，P〉0．05）。155例患者IBS-QOL总分为71．61±19．22，IBS-QOL总分与HAMA、HAMD评分呈负相关（r=-0．262、-0．268，P均=0．001）。合并焦虑和抑郁或抑郁的患者IBS-QOL总分明显低于无合并焦虑抑郁者（66．05±22．88比77．22±15．35，F=4．412，P=0．005）；除健康担忧和性行为外，6个维度（焦虑不安、行为障碍、躯体意识、食物回避、社会功能和人际关系）得分均明显降低（F=3．309、3．279、4．177、3．765、6．041、3．830，P=0．013、0．012、0．013、0．007、0．001、0．010）。在男性，合并焦虑和抑郁或抑郁患者IBS-QOL总分以及焦虑不安、躯体意识、社会功能3个维度得分低于无焦虑抑郁者（t=2．143、2．110、2．279、3．061，p=0．036、0．039、0．027、0．003），而女性患者则表现在食物回避维度得分明显减低（t=2．812，P=0．008）。既往有重大精神刺激史、受虐待史患者IBS-QOL总分及6个维度（焦虑不安、行为障碍、躯体意识、健康担忧、食物回避和人际关系）得分较无同
Objective To investigate the effects of anxiety and depression on the quality of life （QOL） in patients with irritable bowel syndrome with diarrhea （IBS-D） and the difference in gender. Methods IBS-D patients met the Rome Ⅲ diagnostic and subtyping criteria were consecutively enrolled. The intestinal symptoms, psychological status, and QOL of patients were evaluated using IBS-specific symptom questionnaires, the Hamilton anxiety scale （HAMA）, the Hamilton depression scale （HAMD）, and the Chinese Version of IBS- QOL instrument. The data were analyzed by chi-square test variance analysis, t test or Spearman rank correlation analysis. Results A total of 155 IBS-D patients were enrolled. Among them, 115 were complicated with anxiety and/or depression. The number of male and female with comorbid psychological disorders was 69 cases（71.13%） and 46 cases（79.31%）, respectively, and the difference was not statistically significant （χ^ = 1.267, P= 0.26）. Compared with 40 patients without anxiety or depression, there was no statistically significant difference （F=1. 143, P〉0.05） in the scores of intestinal symptoms in 59 patients with comorbid anxiety alone and 56 patients with anxiety and/or depression （20.85±5.84 vs. 21.71±7.47 vs. 22.87±6.09）. The total IBS-QOL score of the 155 patients was 71. 61 ± 19. 22. There was negative correlation between IBS-QOL score and HAMA, HAMD scores（r= -0. 262 and -0. 268, both P=0. 001）. The total IBS-QOL score of patients with comorbid anxiety and depression or depression were lower than that of patients without anxiety or depression （66.05±22.88 vs 77.22± 15. 35, F=4. 412, P=0. 005）. Except health worrying and sexual, the scores in six dimensions（including dysphoria, interference with activity, body image, food avoidance and social reaction） were all significantly decreased （F=3. 309, 3. 279, 4. 177, 3. 765, 6. 041 and 3. 830, P=0. 013, 0. 012, 0. 013, 0. 007, 0. 001 and 0. 010）. In male patients, the total score of IBS-QOL
出处
《中华消化杂志》
CAS
CSCD
北大核心
2015年第9期599-605,共7页
Chinese Journal of Digestion
基金
“十一五”国家科技支撑计划（2007BA104801）
863计划课题（2010AA023007）
国家国际科技合作专项（2014DFA31850）
关键词
腹泻型肠易激综合征
焦虑
抑郁
生命质量
性别
Irritable bowel syndrome with diarrhea
Anxiety
Depression
Quality of life
Gender
