汶川地震灾区中学教师肠易激综合征的患病率和相关因素
摘要
目的:研究肠易激综合征(IBS)在地震灾区(汶川)中学教师中的患病率、发病特征、致病相关危险因素.方法:采用多级随机抽样方法,随机抽取地震灾区和非灾区3所中学269名教师进行IBS的流行病学调查.结果:校正后符合罗马Ⅱ诊断标准IBS的患病率为22.5%(95%CI:17.3%-24.7%).其中地震灾区患IBS有38例,患病率为27.9%(95%CI:20.4%-35.4%),非地震灾区患IBS有17例,患病率为15.7%(95%CI:8.8%-22.6%),经比较IBS在地震灾区的教师中患病率高于非灾区,差异有统计学意义(P<0.05);通过HAD量表调查发现,地震灾区和非灾区教师在焦虑焦虑和抑郁状况方面没有统计学意义,而患IBS教师发生率要高于非IBS教师,有统计学意义(P<0.05).结论:地震灾区教师IBS的患病率27.9%,高于非灾区教师的患病率.非灾区教师生理机能优于灾区教师,在焦虑和抑郁状况方面患IBS教师发生率要高于非IBS教师,说明地震应激事件可加重地震灾区教师的IBS发病,使其病情复杂化和治疗难度加大.
AIM:To analyze the prevalence,clinical characteristics,and risk factors for irritable bowel syndrome(IBS)among middle school teachersin areas affected by Wenchuan earthquake.METHODS:Multistage random sampling was adopted to select 269 teachers from three middle schools in earthquake-affected areas and three in non-affected areas to conduct epidemiological investigation of IBS.RESULTS:The overall prevalence of IBS,which was diagnosed according to the revised Rome II criteria,was 22.5%(95%CI:17.3%-24.7%).The prevalence of IBS among teachers in earthquakeaffected areas was significantly higher than that in non-affected areas(27.9%vs 15.7%,P<0.05).No significant difference was found in the preva-lence of anxiety and depression between teachers in earthquake-affected areas and those in non-affected areas.However,the prevalence of anxiety and depression was significantly higher in teachers with IBS than in those without IBS(P<0.05).CONCLUSION:The prevalence of IBS among teachers was higher in earthquake-affected areas than in non-affected areas.The prevalence of anxiety and depression was higher in teachers with IBS than in those without IBS.Earthquake experience might increase the prevalence of IBS among middle school teachers.
AIM:To analyze the prevalence,clinical characteristics,and risk factors for irritable bowel syndrome(IBS)among middle school teachersin areas affected by Wenchuan earthquake.METHODS:Multistage random sampling was adopted to select 269 teachers from three middle schools in earthquake-affected areas and three in non-affected areas to conduct epidemiological investigation of IBS.RESULTS:The overall prevalence of IBS,which was diagnosed according to the revised Rome II criteria,was 22.5%(95%CI:17.3%-24.7%).The prevalence of IBS among teachers in earthquakeaffected areas was significantly higher than that in non-affected areas(27.9%vs 15.7%,P<0.05).No significant difference was found in the preva-lence of anxiety and depression between teachers in earthquake-affected areas and those in non-affected areas.However,the prevalence of anxiety and depression was significantly higher in teachers with IBS than in those without IBS(P<0.05).CONCLUSION:The prevalence of IBS among teachers was higher in earthquake-affected areas than in non-affected areas.The prevalence of anxiety and depression was higher in teachers with IBS than in those without IBS.Earthquake experience might increase the prevalence of IBS among middle school teachers.
引文
1胡品津,方秀才,肠易激综合征诊断和治疗.第1版.北京:科学出版社,2009:12-18;47-48
2刘平,蒋兰慧,杨磊,王力,林明福,邱仁义,吴坎坎,张林,李幼平.汶川地震225位遇难学生父母精神状况的横断面调查.中国循证医学杂志2010;10:653-657
3罗兴伟,高雪屏,蔡太生,陈晋东,刘哲宁,郭锐,付晓阳,戴建峰.汶川地震亲历者心理健康状况调查.中国临床心理学杂志2008;16:571-573
4潘国宗,鲁素彩,柯美云,韩少梅,郭慧平,方秀才.北京地区肠易激综合征的流行病学研究:一个整群、分层、随机的调查.中华流行病学杂志2000;21:26-29
5Brazier JE,Harper R,Jones NM,O'Cathain A,Thomas KJ,Usherwood T,Westlake L.Validating the SF-36health survey questionnaire:new outcome measure for primary care.BMJ1992;305:160-164
6徐志洁,段丽萍,王琨,夏志伟,林三仁.焦虑和抑郁与胃食管反流病症状发生的相关研究.中华医学杂志2005;85:3210-3215
7张鸣鸣,姜敏.肠易激综合征发病机制研究进展.世界华人消化杂志2009;17:2484-249
8Thijssen AY,Jonkers DM,Leue C,van der Veek PP,Vidakovic-Vukic M,van Rood YR,Clemens CH,Masclee AA.Dysfunctional cognitions,anxiety and depression in irritable bowel syndrome.J Clin Gastroenterol2010;44:e236-e241
9Liu J,Hou X.A review of the irritable bowel syndrome investigation on epidemiology,pathogenesis and pathophysiology in China.J Gastroenterol Hepatol 2011;26 Suppl3:88-93
10Schmulson M,Vargas JA,López-Colombo A,Remes-Troche JM,López-Alvarenga JC.Prevalence and clinical characteristics of the IBS subtypes ac-cording to the Rome III criteria in patients from a clinical,multicentric trial.A report from the Mexi-can IBS Working Group.Rev Gastroenterol Mex2010;75:427-438
11郑仕诚,付万朝,董晓薇,刘忠,周骥,王一平,张强.地震灾区(汶川)中学生肠易激综合征患者的焦虑性情绪障碍状况分析.四川医学2010;31:876-878
12李明阳,王志强,孙刚,杨云生.军人在汶川地震中功能性胃肠病发病的调查及相关因素.世界华人消化杂志2010;18:1594-1597
13Endo Y,Shoji T,Fukudo S,Machida T,Machida T,Noda S,Hongo M.The features of adolescent irritable bowel syndrome in Japan.J Gastroenterol Hepatol2011;26Suppl3:106-109
14Gwee KA.Post-Infectious Irritable Bowel Syn-drome,an Inflammation-Immunological Model with Relevance for Other IBS and Functional Dys-pepsia.J Neurogatroenterol Motil2010;16:30-34
15Hsueh HF,Jarrett ME,Cain KC,Burr R L,Deechakawan W,Heitkemper MM.Does a self-management program change dietary intake in adults with irritable bowel syndrome Gastroenterol Nurs2011;34:108-116
2刘平,蒋兰慧,杨磊,王力,林明福,邱仁义,吴坎坎,张林,李幼平.汶川地震225位遇难学生父母精神状况的横断面调查.中国循证医学杂志2010;10:653-657
3罗兴伟,高雪屏,蔡太生,陈晋东,刘哲宁,郭锐,付晓阳,戴建峰.汶川地震亲历者心理健康状况调查.中国临床心理学杂志2008;16:571-573
4潘国宗,鲁素彩,柯美云,韩少梅,郭慧平,方秀才.北京地区肠易激综合征的流行病学研究:一个整群、分层、随机的调查.中华流行病学杂志2000;21:26-29
5Brazier JE,Harper R,Jones NM,O'Cathain A,Thomas KJ,Usherwood T,Westlake L.Validating the SF-36health survey questionnaire:new outcome measure for primary care.BMJ1992;305:160-164
6徐志洁,段丽萍,王琨,夏志伟,林三仁.焦虑和抑郁与胃食管反流病症状发生的相关研究.中华医学杂志2005;85:3210-3215
7张鸣鸣,姜敏.肠易激综合征发病机制研究进展.世界华人消化杂志2009;17:2484-249
8Thijssen AY,Jonkers DM,Leue C,van der Veek PP,Vidakovic-Vukic M,van Rood YR,Clemens CH,Masclee AA.Dysfunctional cognitions,anxiety and depression in irritable bowel syndrome.J Clin Gastroenterol2010;44:e236-e241
9Liu J,Hou X.A review of the irritable bowel syndrome investigation on epidemiology,pathogenesis and pathophysiology in China.J Gastroenterol Hepatol 2011;26 Suppl3:88-93
10Schmulson M,Vargas JA,López-Colombo A,Remes-Troche JM,López-Alvarenga JC.Prevalence and clinical characteristics of the IBS subtypes ac-cording to the Rome III criteria in patients from a clinical,multicentric trial.A report from the Mexi-can IBS Working Group.Rev Gastroenterol Mex2010;75:427-438
11郑仕诚,付万朝,董晓薇,刘忠,周骥,王一平,张强.地震灾区(汶川)中学生肠易激综合征患者的焦虑性情绪障碍状况分析.四川医学2010;31:876-878
12李明阳,王志强,孙刚,杨云生.军人在汶川地震中功能性胃肠病发病的调查及相关因素.世界华人消化杂志2010;18:1594-1597
13Endo Y,Shoji T,Fukudo S,Machida T,Machida T,Noda S,Hongo M.The features of adolescent irritable bowel syndrome in Japan.J Gastroenterol Hepatol2011;26Suppl3:106-109
14Gwee KA.Post-Infectious Irritable Bowel Syn-drome,an Inflammation-Immunological Model with Relevance for Other IBS and Functional Dys-pepsia.J Neurogatroenterol Motil2010;16:30-34
15Hsueh HF,Jarrett ME,Cain KC,Burr R L,Deechakawan W,Heitkemper MM.Does a self-management program change dietary intake in adults with irritable bowel syndrome Gastroenterol Nurs2011;34:108-116
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