肠易激综合征患者精神心理因素对生活质量、睡眠质量以及症状严重程度的影响

王超王巧民*宋继中解丽员莎李小萍

安徽医科大学附属省立医院消化内科(230001)

背景：肠易激综合征(IBS)患者多伴有焦虑、抑郁等精神心理障碍，但精神心理障碍对患者的影响尚未完全明确。目的：探讨IBS患者精神心理因素对生活质量、睡眠质量以及症状严重程度的影响。方法：纳入2014年11月—2015年5月安徽医科大学附属省立医院收治的IBS患者101例，采用Zung 焦虑自评量表(SAS)和 Zung 抑郁自评量表(SDS)对患者心理状态进行评估；采用IBS生活质量量表(IBS-QOL)对患者生活质量进行评估；采用匹兹堡睡眠质量指数量表(PSQI)对患者睡眠质量进行评估；采用IBS症状严重程度量表(IBS-SSS)对患者症状严重程度进行评估。对患者精神心理因素、生活质量、睡眠质量以及症状严重程度行相关性分析。结果：57.4%(58/101)的IBS患者伴有不同程度的焦虑和(或)抑郁。101例患者IBS-QOL评分为73.28±12.79，其中以焦虑不安、忌食和健康忧虑影响最为严重。73.3%(74/101)的患者伴有不同程度的睡眠障碍，其中以日间功能障碍、睡眠质量和睡眠效率受损最为严重。101例患者中13例症状为轻度，63例为中度，25例为重度，IBS-SSS评分为 253.00±72.58。相关性分析结果显示焦虑、抑郁与生活质量呈负相关(r=-0.426,P<0.001;r=-0.501,P<0.001)，与睡眠质量呈正相关(r=0.556,P=0.000;r=0.513,P=0.000)，与症状严重程度呈正相关(r=0.231,P=0.020;r=0.357,P<0.001)；生活质量与症状严重程度呈负相关(r=-0.417,P<0.001)。结论：IBS患者具有精神心理障碍以及生活质量、睡眠质量下降的表现，且精神心理障碍愈严重，生活质量、睡眠质量受损愈明显，IBS症状愈严重。

关键词肠易激综合征；生活质量；睡眠质量；症状严重程度；抑郁；焦虑

Effects of Psychological Abnormalities on Life Quality, Sleep Quality and Symptom Severity in Patients with Irritable Bowel Syndrome

WANGChao,WANGQiaomin,SONGJizhong,XIELi,YUANSha,LIXiaoping.

DepartmentofGastroenterology,AnhuiProvincialHospitalAffiliatedtoAnhuiMedicalUniversity,Hefei(230001)

Correspondence to: WANG Qiaomin, Email: wqmin@163.com

Background: Irritable bowel syndrome (IBS) patients are often accompanied by anxiety, depression and other psychological abnormalities, but the effects of psychological abnormalities on daily life have not yet been fully clarified. Aims: To investigate the effects of psychological abnormalities on life quality, sleep quality and symptom severity in IBS patients. Methods: A total of 101 IBS patients admitted from Nov. 2014 to May 2015 at Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled in this study. Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS) were used to evaluate the mental state; IBS-quality of life (IBS-QOL) was used to evaluate the life quality; Pittsburgh sleep quality index (PSQI) was used to evaluate the sleep quality; IBS symptom severity score (IBS-SSS) was used to evaluate the symptom severity. Correlations between psychological factors, life quality, sleep quality and symptom severity were analyzed. Results: 57.4% (58/101) of IBS patients were accompanied by varying degrees of anxiety and/or depression. The IBS-QOL score of 101 patients was 73.28 ± 12.79, in which anxiety, loss of appetite and health concerns were the most severely affected. 73.3% (74/101) of IBS patients were accompanied by varying degrees of sleep disorders, in which daytime dysfunction, sleep quality and sleep efficiency were the most severely affected. Of the 101 IBS patients, the symptom of 13 cases was mild, 63 cases was moderate and 25 cases was severe. IBS-SSS score was 253.00±72.58. Correlation analysis showed that anxiety, depression were negatively correlated with life quality (r=-0.426,P<0.001;r=-0.501,P<0.001) and positively correlated with sleep quality (r=0.556,P=0.000;r=0.513,P=0.000) and symptom severity (r=0.231,P=0.020;r=0.357,P<0.001). Life quality was negatively correlated with symptom severity (r=-0.417,P<0.001). Conclusions: IBS patients have psychological abnormalities and their life and sleep qualities are decreased, the more serious the psychological abnormalities, the more damage on life and sleep qualities and the more severe the IBS symptoms.

Key wordsIrritable Bowel Syndrome;Quality of Life;Quality of Sleep;Severity of Symptom;Depression;

Anxiety

功能性肠病(functional bowel disease, FBD)是消化系统常见病和多发病，其发病可能是生理、精神心理和社会因素相互作用的结果，其中精神心理因素越来越受到临床医师的重视。……