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
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摘要
目的分析地震灾区中学生肠易激综合征(IBS)患者的焦虑性情绪障碍状况,为寻找IBS发生的主要原因和治疗提供依据。方法采用多级整群随机抽样方法 ,使用IBS的罗马II诊断标准和儿童焦虑性情绪障碍筛查表对地震灾区和非地震灾区,极重灾区和一般灾区的6所高完中3403名中小学生同步进行流行病学调查和焦虑性情绪障碍状况调查。结果①校正后罗马II诊断标准IBS的患病率是23.1%,男女患病率和年级之间的患病率差异无统计学意义(P>0.05);②地震灾区IBS学生和非IBS学生的发病率与地震发生时情形(如是否目睹房屋倒塌、是否被房屋掩埋、是否看到遗体或残肢、是否受伤、是否因受伤导致伤疤或残疾、是否看到他人受伤或遇难等)均无统计学意义(P>0.05);③分层作Man-WhitneyTest秩和检验,地震灾区患IBS的学生中有失眠和静坐不能症状的比例明显高于非地震灾区的学生,差异有统计学意义(P<0.05);④在儿童焦虑性情绪障碍筛查表(SCARED量表)5个领域的分值比较中,地震灾区的IBS学生的焦虑性情绪障碍倾向发生率高于非IBS学生,也高于非地震灾区患IBS的学生,差异均有统计学意义(P<0.05)。结论我们发现地震灾区患IBS的学生,焦虑性情绪障碍倾向发生率高于非IBS学生和非地震灾区患IBS的学生,虽与地震发生时各种情形的刺激无直接关系,但它们诱发中学生的焦虑性情绪障碍是肯定的,说明焦虑等精神因素对IBS的致病是一个累积结果 。
Objective To analyze the psychological anxious status of middle school students with irritable bowel syndrome(IBS)in earthquake area,and research the main reason of IBS for treatment.Cluster random sampling method,IBS ROME Ⅱ diagnostic criteria and The screen for child anxiety-related emotional disorders(SCARED)were adopted.Epidemiological and anxious emotional disorder investigation were carried out simultaneously in earthquake area and non-earthquake area,normal distress area and serious distress area related to 6 schools about 3403 primary and middle school students.①Morbidity rate of IBS uesed ROME II is 23.1%,there was no statistical significance between males and females,also among all grades(P>0.05);②There was no statistical significance between IBS students′morbidity rate and none,who suffered different status in earthquake(such as if or not seen house collapse,buried,seen mortal remains or disabled limbs,if or not wounded,remained scars or mutilated,seen anyone wouned or died,and so on(P>0.05);③Man-Whitney rank Test was used.The incidence rate of anypnia and akathisia about IBSs in earthquake area was higher than none and the difference was statistical significance(P<0.05);④Compared in 5 aspects with SCARED,the incidence rate of anxiety emotional disorders about IBS students in earthquake was higher than the non-IBSs,also higher than the non-earthquake area'IBSs,and the difference was statistical significance(P<0.05).The incidence rate of anxiety emotional disorders about IBS students in earthquake was higher than the non-IBSs,also higher than the non-earthquake area'IBSs,which didn't relate to status in earthquake.The earthquake maybe induce IBS students′ anxiety emotional disorders,and the reason of IBS was discripted as an accumulated effection of psychological factors.
Objective To analyze the psychological anxious status of middle school students with irritable bowel syndrome(IBS)in earthquake area,and research the main reason of IBS for treatment.Cluster random sampling method,IBS ROME Ⅱ diagnostic criteria and The screen for child anxiety-related emotional disorders(SCARED)were adopted.Epidemiological and anxious emotional disorder investigation were carried out simultaneously in earthquake area and non-earthquake area,normal distress area and serious distress area related to 6 schools about 3403 primary and middle school students.①Morbidity rate of IBS uesed ROME II is 23.1%,there was no statistical significance between males and females,also among all grades(P>0.05);②There was no statistical significance between IBS students′morbidity rate and none,who suffered different status in earthquake(such as if or not seen house collapse,buried,seen mortal remains or disabled limbs,if or not wounded,remained scars or mutilated,seen anyone wouned or died,and so on(P>0.05);③Man-Whitney rank Test was used.The incidence rate of anypnia and akathisia about IBSs in earthquake area was higher than none and the difference was statistical significance(P<0.05);④Compared in 5 aspects with SCARED,the incidence rate of anxiety emotional disorders about IBS students in earthquake was higher than the non-IBSs,also higher than the non-earthquake area'IBSs,and the difference was statistical significance(P<0.05).The incidence rate of anxiety emotional disorders about IBS students in earthquake was higher than the non-IBSs,also higher than the non-earthquake area'IBSs,which didn't relate to status in earthquake.The earthquake maybe induce IBS students′ anxiety emotional disorders,and the reason of IBS was discripted as an accumulated effection of psychological factors.
引文
[1]胡品津,方秀才.肠易激综合征诊断和治疗[M].第1版.北京:科学出版社,2009,21～22,37～38,41～71
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[4]王凯,苏林雁,朱焱,等.儿童焦虑性情绪障碍筛查表的中国城市常模[J].中国临床心理学杂志,2002,10(4):270～272
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[7]Nicholl BI,Halder SL,Macfarlane GJ,et al.Psychosocial risk markers for new onset irritable bowel syndrome-results of a large prospective population-based study[J].Pain,2008,137(2):147～155
[2]李小麟,张麒,胡晓林,等.四川5.12地震住院伤员心身状态调查及急性期心理干预[J].华西医学,2009,24(10):2505～2508
[3]周惠清,李定国,宋艳艳,等.青少年肠易激综合征调查表的制定及考评[J].中华消化杂志,2006,26(2):80～82
[4]王凯,苏林雁,朱焱,等.儿童焦虑性情绪障碍筛查表的中国城市常模[J].中国临床心理学杂志,2002,10(4):270～272
[5]Drossman DA,Corazziari E,Talley NJ,et al,Roma II:a multinational consensus document on functional gastrointestinaldisorders[J].Gut,1999,45(1):1～81
[6]张鸣鸣,姜敏.肠易激综合征发病机制研究进展[J].世界华人消化杂志,2009,17(24):2484～2490
[7]Nicholl BI,Halder SL,Macfarlane GJ,et al.Psychosocial risk markers for new onset irritable bowel syndrome-results of a large prospective population-based study[J].Pain,2008,137(2):147～155
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