功能性肛门直肠疾病患者的精神心理学评估

Psychological Estimation on the Functional Anorectal Disorder

为探讨精神心理因素异常与功能性肛门直肠疾病（FARD）的相关性，本研究对66例FARD患者（试验组）进行生活事件量表和症状自评量表90（SCL-90）测试，并将生活事件得分与38名健康体检者（对照组）进行对比分析，将SCL90各因子得分与常模进行对比分析。结果显示，（1）生活事件：两组正性事件得分差异元统计学意义，P〉0．05；而负性事件得分试验组明显高于对照组，P〈0．05。（2）SCL-90测定：①功能性肛门直肠疼痛患者躯体化、抑郁、焦虑、精神病性因子得分与常模比较，差异有统计学意义，P〈0．05。②功能性排便障碍患者各因子得分与常模相比，除了敌对因子差异无统计学意义外，其他因子差异均有统计学意义，P〈0．05。③功能性大便失禁患者各因子得分与正常成人常模相比，躯体化、强迫、人际关系敏感、抑郁、焦虑和精神病性因子得分差异有统计学意义，P〈0．05。④FARD患者各因子得分与正常成人常模相比，除了偏执因子差异无统计学意义外，其他因子差异均有统计学意义，P〈0．05。结果表明，精神心理因素异常与FARD发病关系密切。在生物心理一社会医学模式下，对此类患者的治疗除药物与手术治疗外，应进行心理治疗。

The objective of the study was to estimate the correlation between psychological factor abnormality and functional anorectal disorders（FARD）. Sixty six patients with FARD were recruited in the study in which the life event scale（LES） and symptom checklist 90（SCL-90） were used （the study group）, their scores of LES were compared with that of 38 healthy persons（the control group） and the scores of SCL-90 of the study group were compared with that of the SCL- 90 scles in the national norms. The LES results showed that there was no statistical difference in positive events scores between the study group and the control group（ P 〉0.05） ,while the scores of negative events were higher in the study group than that in the control group（ P 〈0.05）. While tha SCL-90 results showed that 1）there was statistical difference in the aspects of somatization, depression, anxiety and psychotic factors between functional anorectal pain persons and national norms（ P 〈0.05）;2）there was statistical difference in all the factors（except hostile factor） between the persons with functional disorders of defecation and the national norms（ P 〈0. 05）;3） there was statistical difference in somatization, compulsion, sensitiveness of inter-personal relations, depression,anxiety and psychotic factor between functional fecal incontinence persons and national norms（ P 〉0.05） ：and 4）there was statistical difference in all the factors（except paranoid factor） between FARD persons and normal adult national norms（ P 〈0.05）. It is concluded that disorders of psychological factors are closely correlated with FARD,and according to the bio psycho-social model psychological therapy is necessary in addition to drugs and surgery in the treatment of FARD.