中国人群肠易激综合征患病率和相关危险因素的Meta分析

A meta-analysis of the prevalence and risk factors of irritable bowel syndrome in Chinese community

目的 探讨中国人群肠易激综合征（IBS）的患病率和相关危险因素.方法 从英文数据库PubMed、Web of Science、the Cochrane Library和中文数据库中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库（Wanfang data）和维普数据库（VIP）检索在中国人群中开展的关于IBS的横断面研究.质量评价采用美国卫生保健质量和研究机构（AHRQ）推荐的横断面研究质量评价标准.所有数据合并、发表偏倚检测和敏感性分析均采用Stata 12.0软件.结果 共23篇横断面研究被纳入.除抑郁对IBS患病率影响的分析以外,其他各项分析纳入的文献无明显发表偏倚.中国人群IBS总患病率为6.5％,女性患病率高于男性（8.1％比6.8％,OR=1.23,95％ CI 1.09 ～ 1.38）,30 ～ 59岁患病率较高（6.9％,OR=1.22,95％CI 1.12～ 1.32）.肠道感染史（OR=2.39,95％ CI1.69～ 3.38）、焦虑（OR=2.95,95％CI 1.94 ～4.49）、抑郁（OR=1.85,95％CI 1.11 ～3.09）、食物过敏（OR =2.80,95％ CI2.12～3.67）、饮酒（OR=I.15,95％ CI 1.07 ～ 1.24）均增加中国人IBS的患病风险;城市和农村（城市人群相对于农村人群的OR=0.97,95％ CI0.72～1.29）以及是否接受过高等教育（接受过高等教育相对于未接受高等教育人群的OR=0.85,95％ CI0.70～1.03）对IBS患病风险无显著影响.亚组分析显示,各时期采用的不同诊断标准对患病率统计结果有一定影响：Manning标准下为11.8％,RomeⅡ标准下为4.4％,RomeⅢ标准下为8.9％.结论 中国人群IBS总患病率为6.5％,发病高峰年龄为30 ～ 59岁.女性、肠道感染史、焦虑、抑郁、食物过敏、饮酒是中国人群IBS发病的危险因素.

Objective To estimate the prevalence and risk factors for irritable bowel syndrome （IBS） in China.Methods Cross-sectional studies relevant to IBS conducted among Chinese were identified through the databases including PubMed,Web of Science,the Cochrane Library,CBM,CNKI,Wanfang data and VIP.Quality of studies was assessed according to the criteria for cross-sectional studies recommended by Agency for Healthcare Research and Quality（AHRQ）.Analysis of data,publication bias and sensitivity were performed with Stata （Version 12.0）.Results A total of twenty-three studies were extracted.No obvious publication bias was detected in all analysis except the effect of depression on IBS prevalence.Pooled prevalence of IBS in China was 6.5％.IBS was more common in women than in men （8.1％ vs 6.8％;OR=1.23,95％CI 1.09-1.38） and high rate in age group between 30 to 59 years （6.9％ ; OR =1.22,95％ CI 1.12-1.32）.Intestinal infection history（OR =2.39,95％ CI 1.69-3.38）,anxiety （OR =2.95,95 ％ CI 1.94-4.49）,depression （OR =1.85,95 ％ CI 1.11-3.09）,food allergy （OR =2.80,95％ CI 2.12-3.67） and alcohol consumption （OR =1.15,95％ CI 1.07-1.24） might increase the risk for IBS.There were no significant difference of IBS prevalence between urban and rural areas （OR =0.97,95％ CI 0.72-1.29）,neither in different education classes （OR =0.85,95％ CI 0.70-1.03）.Sub-group analysis showed IBS prevalence varied apparently with different diagnostic criteria：prevalence defined by Manning was 11.8％ and by Rome Ⅱ and Rome Ⅲ prevalence values were 4.4％ and 8.9％ respectively.Conclusions Pooled prevalence of IBS in China was 6.5％.IBS is more common in age group between 30 to 59 years.Female,history of intestinal infection,anxiety,depression,food allergy and alcohol consumption were risk factors for IBS in Chinese population.