早期负性生活事件对成人肠易激综合征发病的影响

Effect of Early Adverse Life Events on Adult Irritable Bowel Syndrome

背景:肠易激综合征(IBS)是一种临床常见的功能性肠病。既往研究显示,早期负性生活事件(EALs)与IBS的发生密切相关,但国内相关研究报道较少。目的:初步探讨儿童期虐待这一EALs对成人IBS发病的影响。方法:收集2017年10月—2018年4月同济大学附属同济医院确诊IBS患者56例(病例组),同期健康体检者50名作为对照组,采用儿童期虐待问卷(CTQ)和健康调查简表(SF-36)评估两组人群的EALs发生情况和生活质量,并进一步采用IBS症状严重程度量表(IBS-SSS)、SF-36、IBS生活质量量表(IBS-QOL)对经历与未经历儿童期虐待IBS患者进行评估、比较。结果:病例组CTQ总分和儿童期受虐率均显著高于对照组(P <0. 05),SF-36躯体疼痛、健康状况、精力、社会功能、精神健康维度评分显著低于对照组(P <0. 05)。经历儿童期虐待IBS患者的IBS-SSS评分显著高于未经历儿童期虐待者(P <0. 05),SF-36生理机能、健康状况、精力、社会功能、精神健康维度评分、IBS-QOL焦虑不安、行为障碍、躯体意念、健康忧虑、社会反应、性行为、人际关系维度评分显著差于未经历儿童期虐待者(P <0. 05)。结论:EALs与成人IBS发病有明显联系,并对发病后的症状严重程度、患者生活质量和社会功能有显著影响。

Background:Irritable bowel syndrome(IBS)is a commonly seen functional bowel disorder in clinical practice.Previous researches demonstrated that early adverse life events(EALs)were associated with the development of IBS.However,there are few researches focused on this field in China.Aims:To explore the effect of childhood abuse,a type of EALs,on the development of IBS in adults.Methods:Fifty-six IBS patients and 50 healthy subjects in Tongji Hospital of Tongji University from Oct.2017 to Apr.2018 were enrolled.The EALs and quality of life of these two groups were evaluated using Childhood Trauma Questionnaire(CTQ)and the MOS 36-Item Short-Form Health Survey(SF-36)scale.Furthermore,Irritable Bowel Syndrome Severity Scoring System(IBS-SSS),SF-36 and Irritable Bowel Syndrome Quality Of Life(IBS-QOL)scales were compared between IBS patients with and without childhood abuse.Results:The CTQ score and incidence of childhood abuse were significantly higher in IBS group than in control group(P<0.05),while the scores of bodily pain,general health,vitality,social functioning and mental health in SF-36 were significantly lower in IBS group than in control group(P<0.05).Compared with patients without childhood abuse,IBS patients with childhood abuse had a higher IBS-SSS score(P<0.05);the physical functioning,general health,vitality,social functioning and mental health in SF-36 and the dysphoria,interference with activity,body image,health worry,social reaction,sexual intercourse and relationship in IBS-QOL were poorer in patients with childhood abuse than those without(P<0.05).Conclusions:Experience of EALs plays an important role in the development of IBS and might affect the symptom severity,quality of life and social function in adult IBS.