广西高校学生慢性便秘的流行病学调查

Epidemiological investigation of chronic constipation in college students in Guangxi

目的:了解广西区内高校学生慢性便秘(chronic constipation,CC)的患病率、症状特点、相关因素,探讨大学生慢性便秘的流行病学特点,进一步探索慢性便秘的病因,为防治慢性便秘提供参考资料.方法:采用分层整群随机抽样的方法,对广西部分高校在校大学生进行慢性便秘调查,运用多因素Logistic回归分析进行慢性便秘的相关因素分析.结果:回收有效问卷2068份,共检出128例符合诊断标准的慢性便秘患者,患病率为6.19%.其中男39例,患病率为4.89%;女89例,患病率为7.01%.慢性便秘患者各项症状中所占比例前3位为排便费力(78.13%)、排便不尽感(62.5%)、粪便呈团块或硬结状(51.56%).重度便秘患者占全部便秘者的10.16%,对待自身便秘76.56%患者选择饮食调节,选用药物治疗者只占16.41%.伴有胃食管反流症状和/或消化不良症状的CC患病率明显增加,均P<0.05.Logistic回归分析结果显示,定时排便(OR=0.345)可减少便秘的发生,患有痔疮(OR=2.976)、直系亲属有便秘(OR=2.290)、SDS粗分>41分(OR=1.729)、常有上腹不适(OR=1.744)可增加便秘患病危险.结论:广西高校在校大学生慢性便秘的患病率为6.19%.最常见的慢性便秘症状为排便费力、排便不尽感、粪便呈团块或硬结状.重度便秘患者所占比例低,大部分患者对待便秘选用饮食调节,少于1/5患者选用药物治疗.伴有胃食管反流症状和/或消化不良症状的人群较正常组CC患病率明显增加.慢性便秘的危险因素与生活方式、痔疮、便秘家族史、心理因素等多方面相关.

AIM： To investigate the epidemiology of chronic constipation （CC） in college students in Guangxi, and to explore the possible pathogenesis of CC. METHODS： A cross-sectional survey was con- ducted in a representative population of college students （n = 2068）, which were selected from four colleges in Guangxi using randomized, stratified, multistage sampling methodology. The data were analyzed by Logistic regression. RESULTS： Overall, 128 responders （6.19%） had CC. The prevalence of CC in males and females was 4.89% and 7.01%, respectively. Straining （78.13%）, incomplete evacuation （62.5%） and hard stools （51.56%） were frequent symptoms.To treat constipation, 76.56% of CC patients chose diet modification, and only 16.41% re- ceived drug intervention. Severe CC patients accounted for 10.16% of all CC patients. The pro- portion of CC patients who had gastroesopha- geal reflux symptoms and/or indigestion symp- toms increased significantly （P 〈 0.05）. Logistic regression analysis showed that regular defeca- tion （OR = 0.345） could reduce the probability of constipation, and hemorrhoids （OR = 2.976）, family history of constipation （OR = 2.290）, SDS score more than 41 （OR= 1.729）, and epigastria discomfort （OR = 1.744） could increase the prob- ability of constipation. CONCLUSION： The prevalence of CC in college students in Guangxi is 6.19%. The most com- mon symptoms of CC are straining, incomplete evacuation and hard stools. The proportion of severe CC patients is low. Most of CC patients chose diet modification to treat constipation, and less than 20% of patients received drug in- tervention. CC combined with gastroesophageal reflux symptoms and/or indigestion symptoms is frequent. Risk factors for CC are related to life style, hemorrhoids, family history of constipa- tion and psychological factors.