中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
18期
8237-8240
,共4页
刘静%刘彬彬%贾林%江舒曼%黄耀星%许鸣%王胜炳
劉靜%劉彬彬%賈林%江舒曼%黃耀星%許鳴%王勝炳
류정%류빈빈%가림%강서만%황요성%허명%왕성병
肠易激综合征%难治性%就医行为%睡眠质量
腸易激綜閤徵%難治性%就醫行為%睡眠質量
장역격종합정%난치성%취의행위%수면질량
Irritable bowel syndrome%Refractory%Care-seeking behaviors%Sleep quality
目的：阐明难治性肠易激综合征（IBS）患者的临床特征、睡眠质量和就医行为。方法采用多中心、前瞻性调查设计（临床试验注册号：ChiCTR-TRC-12001969），以问卷形式对广东地区三家医院难治性 IBS 和非难治性 IBS 患者的常见症状、症状严重程度（IBS-SSS）和睡眠质量指数（PSQI）及就医行为指标进行评定和比较。结果601例IBS中，难治性IBS占142例（23.63%）。难治性IBS组的IBS-SSS总分、症状严重程度为中度和重度的比例显著高于非难治性IBS组（t＝7.358，P＝0.000；χ2＝10.513，P＝0.001；χ2＝14.309，P＝0.000）。难治性IBS组腹胀的发生率显著高于非难治性IBS组（χ2＝5.733，P＝0.017）。难治性IBS组PSQI总分及总分＞5的比例显著高于非难治性IBS组（t＝6.131，P＝0.000；χ2＝34.310， P＝0.000）。难治性IBS组的就诊次数、肠镜次数、年均直接医疗费用均显著高于非难治性IBS组（t＝12.516， P＝0.000；t＝6.407，P＝0.000；t＝9.932，P＝0.000）。结论难治性IBS患者的症状严重，睡眠质量差，就诊和肠镜检查次数多，临床耗费大，值得临床医师高度重视。
目的：闡明難治性腸易激綜閤徵（IBS）患者的臨床特徵、睡眠質量和就醫行為。方法採用多中心、前瞻性調查設計（臨床試驗註冊號：ChiCTR-TRC-12001969），以問捲形式對廣東地區三傢醫院難治性 IBS 和非難治性 IBS 患者的常見癥狀、癥狀嚴重程度（IBS-SSS）和睡眠質量指數（PSQI）及就醫行為指標進行評定和比較。結果601例IBS中，難治性IBS佔142例（23.63%）。難治性IBS組的IBS-SSS總分、癥狀嚴重程度為中度和重度的比例顯著高于非難治性IBS組（t＝7.358，P＝0.000；χ2＝10.513，P＝0.001；χ2＝14.309，P＝0.000）。難治性IBS組腹脹的髮生率顯著高于非難治性IBS組（χ2＝5.733，P＝0.017）。難治性IBS組PSQI總分及總分＞5的比例顯著高于非難治性IBS組（t＝6.131，P＝0.000；χ2＝34.310， P＝0.000）。難治性IBS組的就診次數、腸鏡次數、年均直接醫療費用均顯著高于非難治性IBS組（t＝12.516， P＝0.000；t＝6.407，P＝0.000；t＝9.932，P＝0.000）。結論難治性IBS患者的癥狀嚴重，睡眠質量差，就診和腸鏡檢查次數多，臨床耗費大，值得臨床醫師高度重視。
목적：천명난치성장역격종합정（IBS）환자적림상특정、수면질량화취의행위。방법채용다중심、전첨성조사설계（림상시험주책호：ChiCTR-TRC-12001969），이문권형식대엄동지구삼가의원난치성 IBS 화비난치성 IBS 환자적상견증상、증상엄중정도（IBS-SSS）화수면질량지수（PSQI）급취의행위지표진행평정화비교。결과601례IBS중，난치성IBS점142례（23.63%）。난치성IBS조적IBS-SSS총분、증상엄중정도위중도화중도적비례현저고우비난치성IBS조（t＝7.358，P＝0.000；χ2＝10.513，P＝0.001；χ2＝14.309，P＝0.000）。난치성IBS조복창적발생솔현저고우비난치성IBS조（χ2＝5.733，P＝0.017）。난치성IBS조PSQI총분급총분＞5적비례현저고우비난치성IBS조（t＝6.131，P＝0.000；χ2＝34.310， P＝0.000）。난치성IBS조적취진차수、장경차수、년균직접의료비용균현저고우비난치성IBS조（t＝12.516， P＝0.000；t＝6.407，P＝0.000；t＝9.932，P＝0.000）。결론난치성IBS환자적증상엄중，수면질량차，취진화장경검사차수다，림상모비대，치득림상의사고도중시。
Objective To investigate clinical features, sleep quality and care-seeking behaviors of patients with refractory irritable bowel syndrome(IBS). Methods For a multi-center and prospective investigation(Clinical trial registration number:ChiCTR-TRC-12001969), patients were evaluated by a valid bowel symptoms questionnaire, irritable bowel syndrome-Symptom Severity Scale(IBS-SSS), Pittsburgh Sleep Quality Index(PSQI) and care-seeking behaviors to compare the difference between the refractory IBS and the non-refractory. Results 142 of 601 IBS patients were refractory. The total score of IBS-SSS and the proportion of moderate, severe symptoms in refractory IBS group were higher than those in non-refractory. The prevalence of bloating in refractory IBS group was higher than that in non-refractory. The total score of PSQI and the proportion of PSQI>5 in the refractory IBS group were higher than that in non-refractory. The frequence of care-seeking and colonoscopy examination, direct medical costs in the refractory IBS group were significantly higher than those in non-refractory group. Conclusion Refractory IBS patients have more severe symptoms, poorer sleep quality, more frequent physician visits and colonoscopy examination. Therefore, we should pay more attention to refractory IBS patients in clinical practice.
