肠易激综合征患者心理状态、家庭因素及患病危险因素分析

The survey of psychological status, family factors and risk factors of irritable bowel syndrome

目的探讨肠易激综合征（Irritable Bowel Syndrome，IBS）患者情绪、人格特质、述情特点、疾病观念与求医行为及家庭情况等因素及相关的危险因素。方法2010年7月至2012年1月在云南省第二人民医院消化科门诊及病房，通过方便取样对126例符合罗马Ⅲ标准的IBS患者，进行腹部症状及严重程度调查，同时进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、家庭环境量表（FES）、系统家庭动力学自评量表（SSFD）、艾森克人格问卷（EPQA）、多伦多述情障碍量表（TAS）、疾病观念与求医行为量表（ICHSB）等问卷调查，并将调查结果与126例健康志愿者进行比较。结果1．IBS组抑郁、焦虑、家庭环境因子V、艾森克因子N和因子总分、多伦多述情障碍因子Ⅱ[分别为（40．23±6．96）分，（38．734±7．49）分，（6．78±1．57）分，（13．67±5．37）分，（43．11±7．12）分，（23．12±4．42）分]，高于对照组[分别为（36．43±7．25）分，（32．08±7．25）分，（5．72±2．01）分，（11．22±5．43）分，（39．38±6．75）分，（20．92±3．95）分]；多伦多述情障碍因子Ⅲ（14．734-4．13）分低于对照组（15．11±3．48）分，差异具有显著性（P〈0．05）。2．腹部症状与抑郁、焦虑、系统家庭动力学因子Ⅲ和因子总分、疾病观念与求医行为因子Ⅱ呈正相关，与家庭环境因子I和因子Ⅸ呈负相关。3．焦虑、成功性、年龄、缺乏识别情感和躯体感受的能力为危险因素，受教育年限为保护因素。结论IBS患者易伴有抑郁、焦虑情绪，家庭成员支持少、家庭规则不明确者症状重；焦虑、竞争性活动、缺乏识别情感和躯体感受的能力为危险因素。

Objective To investigate the relationship of emotional character, personality character, alexi-thymia character, disease concept, healthy seeking behaviors, family environment and family dynamics with irritable bowel syndrome（IBS） patients. Methods 126 IBS patients and 126 controls were evaluated by the questionnaires of Self-Rating Anxiety Scale （SAS） , Self-Rating Depression scale （SDS）, Family Environment Scale （FES） , Self-rating Scale of Systemic Family Dynamics （ SSFD）, Eysenck Personality Questionnaire （ EPQ ）, Toronto Alexithy-mia scale （TAS） , self-rating scale of illness conception and health seeking behavior （ICHSB）. Results 1. The scores of SAS, SDS, achievement orientation in FES, nervous and the total scores of EPQ, factor Ⅱ and factor m in TAS were significantly higher in IBS patients than those in healthy subjects（ （40.23 ± 6. 961 ） vs（ 36.43 ± 7.25 ）, （38.73±7.49）vs（32.08 ±7.25）,（6.78±1.57）vs（5.72 ±2.01）,（13.67±5.37）vs（11.22±5.43）, （43.11 ±7.12）vs（39.38 ±6.75） ,（23.12 ±4.42）vs（20.92 ±3.95） ,（14.73 ±4.13）vs（15.11 ±3.48））. 2. The symptoms of IBS patients were positively correlated to the severity of depression, anxiety, systemic logic in SS-FD and factor Ⅱ in ICHSB. The symptoms of IBS patients were negatively correlated to the severity of intimacy and the sense of organization in FES. 3 The risk factors of IBS were anxiety, achievement orientation, age, the factor Ⅱ of TAS. Education level had protective role to IBS. Conclusion The IBS patients have certain psychological problems such as depression, anxiety, competitiveness, lacking self-confident, tension, alexithymia, and lacking of the ability to distinguish between emotion and physical feelings and loving fantasy.