功能性排便障碍患者合并焦虑、抑郁和躯体症状的调查

Investigation of anxiety,depression and somatic symptoms in patients with functional defecation disorders

目的了解功能性排便障碍患者合并焦虑、抑郁及躯体症状阳性率及其危险因素分析。方法选择2020年11月~2021年9月期间就诊于西京消化病院便秘专科门诊的功能性排便障碍患者86例,根据GAD-7、PHQ-9和PHQ-15量表计分,统计患者合并焦虑、抑郁及躯体症状的发生率,并采用Logistics回归分析其危险因素。结果入组患者86例,男性18例(20.9%),女性68例(79.1%),平均年龄(46.7±13.4)岁,中位病程7.5(3~15.3)年。焦虑的发生率80.2%,抑郁的发生率73.2%,躯体症状的发生率94.2%。单因素回归分析可见排便费力(χ^(2)=10.489,P<0.05)和排便不尽感(χ^(2)=9.389,P<0.05)与患者合并躯体症状相关。多因素回归分析显示排便不尽感是患者合并焦虑(OR=4.831,95%CI:1.364~17.117,P<0.05)、抑郁(OR=4.214,95%CI:1.162~15.282,P<0.05)和躯体症状(OR=7.809,95%CI:1.058~57.617,P<0.05)的独立危险因素。结论功能性排便障碍患者极易伴发焦虑、抑郁及躯体症状且患者具有排便不尽症状是合并焦虑、抑郁及躯体症状的独立危险因素。

Objective To investigate the incidence and risk factors of anxiety,depression and somatic symptoms in patients with functional defecation disorders.Methods Eighty-six cases with functional defecation disorders were collected from November 2020 to September 2021 in the Department of Gastroenterology of Xijing Hospital.According to the scores of GAD-7,PHQ-9 and PHQ-15,to investigate the incidence of anxiety,depression and somatic symptom in patients combined with functional defecation disorders,and then the logistics regression was used to analyze the related risk factors.Results Among the 86 patients,eighteen(20.9%)were male and 68(79.1%)were female,with an average age of(46.7±13.4)years and a median disease duration of 7.5(3~15.3)years.The incidence of anxiety was 80.2%,depression was 73.2%and somatic symptom was 94.2%.Univariate regression analysis showed that defecation effort(χ^(2)=10.489,P<0.05)and incomplete defecation(χ^(2)=9.389,P<0.05)were significantly related to patients with somatic symptom.Multivariate regression analysis showed that incomplete defecation was an independent risk factor for patients with anxiety(OR=4.831,95%CI:1.364~17.117,P<0.05),depression(OR=4.214,95%CI:1.162~15.282,P<0.05)and somatic symptom(OR=7.809,95%CI:1.058~57.617,P<0.05).Conclusion Functional defecation disorders is easily combined with anxiety,depression,somatic symptom disorder and other systemic symptoms,and incomplete defecation is highly correlated with anxiety,depression and somatic symptoms in patients with functional defecation disorders.