社区人群中肠易激综合征的症状学特征

Symptomatologic Characteristics of Irritable Bowel Syndrome in Community Population

背景肠易激综合征(IBS)是一种常见的功能性胃肠病,其临床表现复杂。目前对IBS的症状分析多来自临床病例。目的分析社区人群中符合罗马Ⅱ标准的IBS症状人群的症状学特征。方法采用整群、分层、随机抽样的方法,收集到239例符合罗马Ⅱ标准的IBS症状人群,记录其人口统计学资料,以及最近一年内的腹痛或腹部不适和排便习惯等方面的情况。结果本组社区人群中IBS症状人群的病程为1～60年,平均4.2年±3.7年;腹痛或腹部不适以脐周或下腹部为多见,其发生与女性经期和进食关系最大;77.4%的症状人群每次腹痛持续时间一般小于30min。其他常见的IBS相关症状有排便次数增加、黏液便、排便不尽感、腹胀等;较常见的非结肠性消化道症状有恶心、反酸、打嗝、呕吐等;较常见的肠外症状有乏力、女性痛经、头痛或肌肉酸痛等。各IBS亚型中,以腹泻为主型最为多见(74.0%)。结论社区人群中IBS的症状多种多样,且常合并有较多非结肠性消化道症状和肠外症状。

Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, and its clinical manifestation is complicated. The subjects recruited for the analysis of IBS symptoms are mainly from the clinics. Aims: To analyze the symptomatologic characteristics of IBS symptomatic subjects consistent with Rome Ⅱ criteria from community population. Methods: In the stratified randomized study of IBS by cluster sampling, 239 IBS symptomatic subjects defined by Rome Ⅱ criteria were collected. The demographic characteristics, the abdominal pain or discomfort and bowel habits in the previous year of these IBS subjects were recorded. Results: The mean course of IBS symptomatic subjects from community population was 4.2 years±3.7 years with a range of 1 to 60 years; The abdominal pain or discomfort was predominantly located in the lower abdomen or around the navel, and was mainly associated with the menstruation of women and eating; 77.4% of the IBS subjects reported the abdominal pain lasting less than 30 minutes each time. Other IBS-associated symptoms such as more frequent stools, mucus per rectum, incomplete evacuation and abdominal distension also occurred frequently. Meanwhile, there were often upper gastrointestinal symptoms such as nausea, acid regurgitation, hiccup and vomit, and the extraintestinal symptoms such as fatigue, dysmenorrhoea and headache or muscular soreness were also frequently complained by the IBS subjects. The most common IBS subtype was the diarrhea-predominant (74.0%) in the studied IBS subjects. Conclusions: The symptoms of IBS in community population are variegated, and these IBS symptomatic subjects may also frequently complain of upper gastrointestinal symptoms and extraintestinal symptoms.