地震灾区中学生肠易激综合征影响因素的通径分析
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摘要
[目的]探讨地震灾区中学生肠易激综合征(IBS)的影响因素。[方法]选取四川地震灾区3所中学初、高中学生2594人进行问卷调查,采用Logistic回归分析和通径分析方法。[结果]Logistic回归分析显示焦虑对IBS的影响最大,OR值为1.922,95%CI为1.712~2.157。通径分析表明胃肠道感染对IBS有直接作用,失眠、悲观通过焦虑作用对IBS有间接作用,疲劳、自己受伤或被埋、亲人或同学遇难对IBS既有直接又有间接作用。[结论]初步建立了灾区中学生IBS影响因素的作用路径。对地震灾区IBS的患病学生的诊疗应注意了解有无应激事件和焦虑心理。重视接诊过程中的"治疗"作用。
[Objective]To explore the factors affecting irritable bowel syndrome(IBS)among middle-school students in earthquake-stricken areas.[Methods]We surveyed 2594 students by using a questionnaire in three middle schools in the disaster areas of Sichuan Province,and analyzed data with Logistic regression and path analysis.[Results]Logistic regression showed that anxiety was the dominant influential factor for IBS,and the pools OR was 1.992 with a confidence interval(1.712-2.157). Path analysis showed Gastrointestinal infection had direct effect on IBS;Insomnia and pessimism had indirect effect on IBS by way of anxiety;Fatigue,being injured or buried,and relatives or classmates being killed in the earthquake had both direct and indirect effect for them.[Conclusion]The preliminary path model of the factors affecting IBS among middle-school students in earthquake-stricken areas was made. Doctors should pay attention to the IBS students in the disaster areas to determine whether they had something stress and anxiety,and to emphasize the therapeutic effect during diagnosis.
[Objective]To explore the factors affecting irritable bowel syndrome(IBS)among middle-school students in earthquake-stricken areas.[Methods]We surveyed 2594 students by using a questionnaire in three middle schools in the disaster areas of Sichuan Province,and analyzed data with Logistic regression and path analysis.[Results]Logistic regression showed that anxiety was the dominant influential factor for IBS,and the pools OR was 1.992 with a confidence interval(1.712-2.157). Path analysis showed Gastrointestinal infection had direct effect on IBS;Insomnia and pessimism had indirect effect on IBS by way of anxiety;Fatigue,being injured or buried,and relatives or classmates being killed in the earthquake had both direct and indirect effect for them.[Conclusion]The preliminary path model of the factors affecting IBS among middle-school students in earthquake-stricken areas was made. Doctors should pay attention to the IBS students in the disaster areas to determine whether they had something stress and anxiety,and to emphasize the therapeutic effect during diagnosis.
引文
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[2]李定国,刘栋,许小幸,等.青少年肠易激综合征的流行病学调查[J].中华消化杂志,2005,25(5):266-269.
[3]中华医学会消化病学分会.肠易激综合征诊治共识意见[J].中华消化杂志,2003,23(7):427.
[4]陈峰.医用多元统计分析方法[M].第2版.中国统计出版社,2007.1.
[5]孙尚拱.医学多变量统计与统计软件[M].北京大学医学出版社,2000,10.
[6]陈东周.通径分析在流行病学描述性研究中的应用[J].疾病控制杂志,2003,7(4):344-346.
[7]Gick ML,Thompson WG.Negative affect and the seeking of medi cal care in university students with irritable bowel syndrome:a pre liminary study[J].Psychosom Res1997,43:535-540.
[8]Neal KR,Hebden J,Spiller R.Prevalence of gastrointestinal symptoms six months bacterial gastroenteritis and risk factors for de velopment of the irritable bowel syndrome:postal survey of patient[J].Br Med J,1997,314(7083):779-782.
[9]Holly Hazlett Stevens,MichelleG.Craske,Emeran A.Mayer.Prevalence of irritable bowel syndrome among university students.the roles of worry,neuroticism,anxiety sensitivity and visceral anxiety[J].Psychosomatic Research,2003,55:501–505.
[10]韩聚强,李恕军,冯军,等.震后灾区居民胃肠道应激症状现况调查[J].中国健康教育,2009,25(4):278-279.
[2]李定国,刘栋,许小幸,等.青少年肠易激综合征的流行病学调查[J].中华消化杂志,2005,25(5):266-269.
[3]中华医学会消化病学分会.肠易激综合征诊治共识意见[J].中华消化杂志,2003,23(7):427.
[4]陈峰.医用多元统计分析方法[M].第2版.中国统计出版社,2007.1.
[5]孙尚拱.医学多变量统计与统计软件[M].北京大学医学出版社,2000,10.
[6]陈东周.通径分析在流行病学描述性研究中的应用[J].疾病控制杂志,2003,7(4):344-346.
[7]Gick ML,Thompson WG.Negative affect and the seeking of medi cal care in university students with irritable bowel syndrome:a pre liminary study[J].Psychosom Res1997,43:535-540.
[8]Neal KR,Hebden J,Spiller R.Prevalence of gastrointestinal symptoms six months bacterial gastroenteritis and risk factors for de velopment of the irritable bowel syndrome:postal survey of patient[J].Br Med J,1997,314(7083):779-782.
[9]Holly Hazlett Stevens,MichelleG.Craske,Emeran A.Mayer.Prevalence of irritable bowel syndrome among university students.the roles of worry,neuroticism,anxiety sensitivity and visceral anxiety[J].Psychosomatic Research,2003,55:501–505.
[10]韩聚强,李恕军,冯军,等.震后灾区居民胃肠道应激症状现况调查[J].中国健康教育,2009,25(4):278-279.
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