福建省肠易激综合征人群临床症状调查

Survey on Symptoms of Irritable Bowel Syndrome in Fujian Province,China

背景：肠易激综合征（IBS）是最常见的功能性胃肠病之一,分析其临床症状谱的地区差异对疾病的诊断和治疗具有重要意义。目的：初步了解福建省IBS人群的临床症状特点,为其诊治提供依据。方法：收集2011年6月—2012年4月福建省15家三级医院消化内科门诊IBS患者703例,诊断均符合罗马Ⅲ标准。对入组患者进行面谈式调查,调查内容包括人口学资料、病程、相关症状等。结果：703例IBS患者的男女比例为1∶1.3,以35-45岁年龄段最多见（32.4%）;腹泻型IBS（IBS-D）占58.2%,便秘型IBS（IBS-C）占22.6%;主要下消化道症状为腹痛或腹部不适、腹胀和排便异常（包括腹泻、便秘、排便不尽感、黏液便等）。在4个IBS亚型中,混合型IBS（IBS-M）患者临床症状最重（P〈0.05）,IBS-D、IBS-M患者的腹痛症状重于IBS-C患者（P〈0.05）,IBS-C患者的腹胀症状重于IBSD患者（P〈0.05）。32.9%的IBS患者重叠上消化道症状,以餐后饱胀、嗳气最常见,其中68例（9.7%）重叠功能性消化不良。结论：福建省IBS人群半数以上为IBS-D,不同亚型间的临床症状谱存在差异,部分患者可重叠上消化道症状或功能性消化不良。

Background： Irritable bowel syndrome（ IBS） is one of the most common functional gastrointestinal disorders.Analyzing the regional differences of symptomatic profiles may provide guidance for the diagnosis and treatment of IBS.Aims： To preliminarily investigate the symptomatic characteristics of IBS patients in Fujian province,China for the reference of diagnosis and treatment of the disease. Methods： A total of 703 IBS out-patients based on the Rome Ⅲ criteria and presented to the gastroenterological clinic of 15 tertiary hospitals in Fujian Province,China from Jun. 2011 to Apr.2012 were enrolled in a face-to-face survey. The questionnaire mainly included demographic data,course of the disease,and clinical symptoms. Results： In 703 IBS patients,the ratio of male to female was 1∶ 1. 3,and the peak of age was 35-45 years（ 32. 4%）. More than half of the patients were diarrhea-predominant IBS（ IBS-D,58. 2%）,while constipationpredominant IBS（ IBS-C） accounted for 22. 6% of the patients. Abdominal pain / discomfort,abdominal distention and abnormal defecation,including diarrhea,constipation,feeling of incomplete defecation and mucous stool were the most important lower GI symptoms. In the four subtypes of IBS,the symptoms of mixed IBS（ IBS-M） were most serious（ P〈0. 05）. Compared with IBS-C,abdominal pain was more severe in IBS-D and IBS-M（ P〈0. 05）,however,abdominal distention was more severe in IBS-C than in IBS-D（ P〈0. 05）. About one third of the patients（ 32. 9%） were overlapped with upper GI symptoms,and the most common upper GI symptoms were postprandial fullness and eructation. Sixty-eight（ 9. 7%） patients were overlapped with functional dyspepsia. Conclusions： In Fujian Province,China,more than half of the IBS patients were IBS-D. The symptomatic profiles are different between different subtypes of IBS. Some of the IBS patients may be overlapped with upper GI symptoms or functional dyspepsia.