本文關(guān)鍵詞：腸易激綜合征的社會心理因素調(diào)查及危險因素分析，由筆耕文化傳播整理發(fā)布。

        目的腸易激綜合征(Irritable Bowel Syndrome, IBS)是一種以腹痛或腹部不適伴排便習慣改變和(或)糞便性狀改變的功能性腸病,該病缺乏可解釋癥狀的形態(tài)學改變和生化異常。有研究認為,很多腸易激綜合征患者都存在一定的心理功能異常,為進一步了解腸易激綜合征患者的社會心理特征,課題組對云南省第二人民醫(yī)院消化科的126例患者進行了情緒特點、人格特征、述情障礙、疾病觀念、家庭環(huán)境、家庭動力學等社會心理特征調(diào)查,探討這些社會心理特征與腸易激綜合征發(fā)病的關(guān)系。方法2010年至2011年對云南省第二人民醫(yī)院消化科門診的126名腸易激綜合征患者和126名無重大軀體疾病的正常對照進行抑郁量表、焦慮量表、家庭環(huán)境量表、系統(tǒng)家庭動力學自評量表、艾森克人格量表、疾病觀念與求醫(yī)行為量表以及多倫多述情障礙量表等的問卷調(diào)查。結(jié)果腸易激綜合征患者存在一定的社會心理問題,如：①IBS組與對照組在抑郁自評量表方面存在顯著差異(F=4.634；P=0.032)；女性IBS組患者與女性對照者抑郁量表得分有顯著差異(F=9.784；P=0.002)。②IBS組與對照組在焦慮自評量表方面存在顯著差異(F=31.716;P<0.001)；IBS組男性患者與女性患者焦慮評分有顯著性差異(女性均值為40.44±7.386；男性均值為36.85±7.197；T=-2.758；P<0.05)；女性患者與女性對照者焦慮評分有顯著性差異(F=39.442;P<0.001)。③IBS組與對照組在家庭環(huán)境量表的因子V成功性上存在顯著差異(F＝11.492；P<0.001)；女性IBS組患者與女性對照者之間家庭環(huán)境量表在因子Ⅳ獨立性(F=6.870;P=0.010)和因子V成功性(F=9.196：P<0.003)方面有顯著性差異。④IBS組與對照組在系統(tǒng)家庭動力學自評量表間差異不明顯。⑤男性IBS患者與男性對照者的疾病觀念與求醫(yī)行為問卷量表在求醫(yī)方式與行為上有顯著差異(F=4.463;P=0.037)。⑥IBS組與對照組在艾森克量表因子N：神經(jīng)質(zhì)(F=15.528;P<0.001)和艾森克量表因子總分(F=8.241；P=0.004)上存在顯著差異；IBS組男女患者之間EPQ量表在因子L被試者的掩飾度上存在顯著差異(T=-3.095；P=0.002)；女性IBS患者與女性對照者在艾森克因子N：神經(jīng)質(zhì)(F=12.623;P=<0.001)及因子總分(F=6.386;P=0.013)方面存在顯著差異。⑦IBS組與對照組在多倫多述情障礙因子Ⅱ缺乏認識和區(qū)別情感和軀體感受的能力(F=8.613;P<0.05)和因子Ⅲ少幻想(F=6.796；P<0.05)方面存在顯著差異；男性IBS組患者與男性對照者在因子Ⅱ(F=7.908;P<0.05)和因子Ⅲ(F=5.198：P<0.05)方面存在顯著性差異。⑧IBS患者腹部癥狀與SDS總分、與SAS總分、系統(tǒng)家庭動力學自評量表在因子Ⅲ系統(tǒng)邏輯、疾病觀念與求醫(yī)行為問卷在因子Ⅱ成年時期對疾病與健康的觀念、態(tài)度呈正相關(guān)(R=0.198,P<0.05；R=0.217；P<0.05；R=0.189,P<0.05；R=0.178,P<0.05)； IBS患者腹部癥狀與家庭環(huán)境量表在因子Ⅰ親密度(R=-0.186；P<0.05)和因子Ⅸ組織性(R=-0.198；P<0.05)上存在負相關(guān)。⑨抑郁、家庭環(huán)境量表中因子V成功性即喜歡將一般性活動變?yōu)槌删托曰蚋偁幮曰顒�、年齡及TAS因子Ⅱ即缺乏認識和區(qū)別情感和軀體感受的能力為IBS患者發(fā)病的危險因素；焦慮、艾森克因子N為IBS患者抑郁發(fā)生的危險因素；抑郁、艾森克因子N、家庭環(huán)境量表因子總和、疾病觀念與求醫(yī)行為問卷因子總和為IBS患者焦慮發(fā)生的危險因素。結(jié)論腸易激綜合征患者存在一定的社會心理問題,他們主訴的腹痛、腹脹、腹瀉、便秘等情況可能跟患者的抑郁、焦慮情緒、喜歡把一般性活動變?yōu)楦偁幮曰顒�、自己及家庭成員間不夠自信、容易緊張、擔憂、情緒起伏較大、缺乏區(qū)分情感和軀體感受能力及愛幻想等有關(guān),建議這部分患者的治療中可以結(jié)合新的治療方式,如抗抑郁藥治療或心理治療等。

    Objective Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorders with abdominal pain and abdominal discomfort. It has a change with bowl evacuation habit and feces traits. This disease is lack of the change with morphology and biochemistry to explain the symptom. Many researches showed that the patients with IBS had certain social psychological problems. In order to further understand the social psychological factors about IBS patients, our research group make an investigation in emotional character, personality character, alexithymia character, disease concept,healthy seeking behaviors, family environment and family dynamics to IBS patients and control in gastroenterology department of the second people’s hospital in Yunnan province.Methods We make an investigation to IBS patients and control in gastroenterology department of the second people’s hospital in Yunnan province with questionnaires of SAS, SDS, FES-CV, SSFD, EPQ, ICHSB, TAS.Results The irritable bowel syndrome patients have the following social psychological problems.①The scores of depression were significantly higher in IBS patients than those in healthy subjects (F=4.634; P=0.032). The scores of depression were significantly higher in the female patients of IBS group than those in the female of control group (F=9.784; P=0.002)②The scores of anxiety were significantly higher in IBS patients than those in healthy subjects (F=31.716; P<0.001). The scores of anxiety were significantly higher in the female patients of IBS group than those in the male patients of IBS group (the mean of female is40.44±7.386; the mean of male is36.85±7.197; T=-2.758; P<0.05). The scores of anxiety were significantly higher in the female patients of IBS group than those in the female of control group (F=39.442; P<0.001)③The scores of achievement orientation in FES were significantly higher in IBS patients than those in healthy subjects (F=11.492; P<0.001). The scores of independence (F=6.870; P=0.010) and achievement orientation (F=9.196; P<0.003) in FES were significantly higher in the female patients of IBS group than the female of control group.④The scores of SSFD were no diferent between IBS patients and healthy subjects.⑤The scores of health seeking behavior of ICHSB were significantly higher in male patients of IBS group than those in male healthy subjects (F=4.463; P=0.037).⑥The scores of nervosity (F=15.528; P<0.001) and the total points (F=8.241; P=0.004) of EPQ were significantly higher in IBS patients than those in healthy subjects. The scores of hide degrees in EPQ were significantly higher in the female patients of IBS group than those in the male patients of IBS group (T=-3.095; P=0.002). The scores of nervosity (F=12.623; P=<0.001) and the total points (F=6.386; P=0.013) of EPQ were significantly higher in the female patients of IBS group than those in the female of control group.⑦The scores of factor II (F=8.613; P<0.05) and factor III (F=6.796; P<0.05) in TAS were significantly higher in IBS patients than those in healthy subjects. The scores of factor II (F=7.908; P<0.05) and factor III (F=5.198; P<0.05) in TAS were significantly higher in the male patients of IBS group than those in the male of control group.⑧The symptom of IBS patients is positively correlated to the severity of depression R=0.198; P<0.05). anxiety(R=0.217; P<0.05),. system logic in SSFD (R=0.189; P<0.05) and factor II in ICHSB (R=0.178; P<0.05) The symptom of IBS patients is negatively correlated to the severity of intimacy (R=-0.186; P<0.05) and the sense of organization (R=-0.198; P<0.05) in FES.⑨The risk factors of IBS are depression, achievement orientation, age, the factor II of TAS. The risk factors to depression of IBS are anxiety and the factor N of EPQ. The risk factors to anxiety of IBS are depression, the factor N of EPQ, the total points of FES and the total points of ICHSB.Conclusion The irritable bowel syndrome patients have certain social psychological problems such as depression, anxiety, competitiveness, lacking self-confident, tension, alexithymia, lacking of the ablity to distinguish between emotion and physical feelings and loving fantasy.

          腸易激綜合征的社會心理因素調(diào)查及危險因素分析

摘要5-7Abstract7-9英文縮略詞表10-11前言11-19研究對象與方法19-23結(jié)果23-48討論48-54結(jié)論54-55參考文獻55-61綜述61-72    參考文獻68-72攻讀學位期間發(fā)表文章情況72-73致謝73

  本文關(guān)鍵詞：腸易激綜合征的社會心理因素調(diào)查及危險因素分析，，由筆耕文化傳播整理發(fā)布。