不同证型腹泻型肠易激综合征患者生存质量评价分析

Evaluation of Quality of Life in Diarrhea-predominant Irritable Bowel Syndrome Patients with Different Traditional Chinese Medical Patterns

【目的】探讨肝郁脾虚证和脾胃虚弱证腹泻型肠易激综合征(IBS-D)患者的生存质量及影响因素。【方法】选择符合罗马Ⅲ诊断标准的IBS-D患者共62例,其中肝郁脾虚证32例,脾胃虚弱证30例,使用中华脾胃系疾病患者报告结局量表(PRO量表)之肠易激综合征量表(CGEDPRO-IBS)进行横断面调查。【结果】IBS-D患者肝郁脾虚组患者生存质量自我总评分低于脾胃虚弱组;肝郁脾虚组患者对本病的担心程度、精力与形色、疼痛与不适、心理方面、社会关系等方面以及心理领域和环境领域的严重程度均高于脾胃虚弱组,差异有统计学意义(P<0.05)。2组IBS-D患者心理领域得分与精力与形色、疼痛与不适、消化功能等方面和生理领域等呈正相关(P<0.05)。IBS-D肝郁脾虚组患者心理领域得分还与独立性领域呈正相关。多元线性回归分析结果显示,2组IBS-D患者生存质量自我总评分均与社会关系方面和环境领域关系最为密切。肝郁脾虚组患者的生存质量自我总评分还与疼痛与不适关系尤为密切。【结论】IBS-D肝郁脾虚组患者生存质量自我总评分低于脾胃虚弱组,在七情应激、心理障碍、社会关系紧张、医疗负担加重等方面的严重程度高于脾胃虚弱组;2组IBS-D患者生存质量均与社会关系和环境领域关系最为密切。

Objective To evaluate the quality of life（QOL） in diarrhea-predominant irritable bowel syndrome（IBS-D） patients with liver-qi stagnation and spleen deficiency pattern and spleen-stomach weakness pattern,and to investigate the influencing factors.Methods According to RomeⅢ criteria of IBS-D,62 IBS-D patients were enrolled into the study.Of the 62 patients,32 were differentiated into liver-qi stagnation and spleen deficiency pattern and 30 into spleen-stomach weakness pattern.QOL of the patients was evaluated with the Chinese Gastroenteric Disease PRO Scale-Irritable Bowel Syndrome Scale（CGEDPRO-IBS）by a cross-sectional survey.Results IBS-D patients with liver-qi stagnation and spleen deficiency had lower self-rating total scores of QOL than those in patients with spleen-stomach weakness,but had higher scores in psychological domain and environment domain,and in fields of worrying about the disease,energy and complexion,pain and discomfort,psychology,and social relations（P〈0.05）.The scores of psychological domain were positively correlated with the score of physiological domain and with the scores of fields of energy and complexion,pain and discomfort,and digestive function in the two groups（P〈0.05）.The scores of psychological domain in liver-qi stagnation and spleen deficiency patients were also positively correlated with the scores of independence domain.The results of multiple linear regression analysis showed that the self-rating total scores of QOL in the two groups were most closely related to the field of social relations and with the environment domain,and the self-rating total scores in liver-qi stagnation and spleen deficiency patients were also closely related with pain and discomfort.Conclusion IBS-D patients with liver-qi stagnation and spleen deficiency have lower self-rating total scores of QOL than the patients with spleen-stomach weakness,and have higher severity in the emotional stress,psychological disorders,social tensions,and medical burden.The QOL of IBS-D patients with the two patterns is most closely related with the field of social relations and the environmental domain.