肠易激综合征患者临床症状特点分析

Analysis of Symptomatic Characteristics of Irritable Bowel Syndrome

背景:肠易激综合征(IBS)是消化科门诊常见的功能性疾病,分析IBS及其亚型之间的临床症状特点对疾病的诊断具有重要指导意义。目的:分析IBS患者及其亚型之间的临床症状特点。方法:对2005年8月～2006年5月在我院消化科门诊行结肠镜检查的连续患者进行问卷调查,根据结肠镜检查结果按罗马Ⅱ标准对每位患者进行临床诊断,统计其中所有IBS患者并进行分型,分析IBS的症状特点并比较三亚型之间临床症状的差异。结果:578例IBS中便秘型IBS(C-IBS)250例(43.3%),腹泻型IBS(D-IBS)290例(50.2%),腹泻便秘交替型IBS(A-IBS)38例(6.6%);其中男251例(43.4%),女327例(56.6%)。C-IBS和A-IBS与D-IBS相比,女性发病为多(P值分别为0.000、0.003);IBS患者在40岁之前随年龄的增长而逐渐增多,40岁之后随年龄的增长而逐渐减少,发病高峰年龄为30～40岁。三型IBS患者之间肠道症状中腹痛、腹胀、便后腹部症状缓解以及大便不尽感发生率有显著性差异(P<0.05);三型IBS均以下腹痛发生率最高。578例IBS患者中有上消化道症状者有316例(54.7%);三型IBS患者之间恶心、食欲下降、早饱、反酸和烧心的发生率有显著差异(P值均<0.05)。结论:三型IBS的临床症状各有特点,上下消化道症状重叠在IBS患者中常见。临床上注意细致区分这些症状特点有助于疾病的初步鉴别诊断。

Background： Irritable bowel syndrome （IBS） is one of the functional disorders commonly seen in our GI out-patient clinic. Analysis of the symptomatic characteristics of IBS and its three subtypes can provide significant guidance for the diagnosis and categorization of IBS. Ahns： To analyze the symptomatic characteristics of IBS and its three subtypes： C- IBS, D-IBS and A-IBS. Methods： Consecutive patients underwent colonoscopy were diagnosed as IBS according to Rome H criteria from August 2005 to May 2006 at Wuhan Union Hospital. These patients were investigated by questionnaire and its symptomatic characteristics were analyzed. Comparison was also made among the three subtypes of IBD. Results： Of the 578 IBS patients, 250 （43.3%） were C-IBS, 290 （50.2%） D-IBS, and 38 （6.6%） A-IBS. 251 （43.4%） were males and 327 （56.6%） females. The male patients were predominant in D-IBS, while the female patients were predominant in C-IBS and A-IBS. The peak age incidence of IBS was between 30 and 40 years old, and the incidence of IBS was higher with increase of age before 40 years old, but lower with increase of age beyond 40 years old. The abdominal pain, abdominal distension and abdominal discomfort relieved after defecation were different among the three subtypes （P〈0.05）. Lower abdominal pain was the most common symptom in all three subtypes. Among the 578 IBS patients, 316 patients （54.7%） had upper GI symptoms. The occurrence of nausea, poor appetite, early satiety, acid reflux and heart burn was also different among the three subtypes （all P〈0.05）. Conclusions： Each of the three subtypes of IBS has its own symptomatic characteristics. Overlapped upper and lower GI symptoms are common in IBS patients. Analysis of these symptomatic characteristics is helpful in the diagnosis and categorization of IBS subtypes.