妊娠肠易激综合征86例临床分析

目的探讨妊娠对肠易激综合征（IBS）的影响以及妊娠期性激素对IBS发病的作用。方法按照罗马Ⅲ标准入选IBS患者86例,其中早、中、晚孕期分别为36例、28例和22例,根据腹部疼痛或不适的严重程度将症状分为轻度、中度和重度3级,根据粪便性状分为腹泻型（IBS—D）、便秘型（IBS—C）、混合型（IBS-M）和不定型（IBS-U）,根据有无重叠功能性消化不良（FD）症状分为重叠组和非重叠组,调查两组患者的性格特征、精神情绪、睡眠状况、焦虑抑郁等;对照组选择同期就诊的120例非妊娠女性患者。对妊娠各期与对照组患者的症状程度、IBS分型及重叠症状发生情况进行比较。结果随着孕期的增加,中度和重度发生率及发作频率有所减少,以肠道动力障碍为表现的IBS—C发生率有所增加（P〈0．05）;早、中孕期与对照组重叠症状的发生率比晚孕期患者有较明显增加。结论妊娠对IBS发病存在较为明显的影响,与妊娠密切有关的性激素水平对肠道动力和功能改变可能起着重要作用。

The influence of gestation on the irritable bowel syndrome

Objective To inquire into the influence factor of gestation on the irritable bowel syndrome （IBS）and the affection of sex hormone of gestation period to the IBS attack. Methods Eighty six female pregnant patients who fulfilled the Rome Ⅲ diagnostic criteria for IBS were selected for this study. According to the week＇ s gestation, 86 patients were divided into early, mid and late-term subgroups with 36,28 and 22 patients, respectively. Based on serious degree of abdominal pain or discomfort, the symptoms were graded as mild, moderate and serious, and the types of IBS-D, IBS-C, IBS-M and IBS-U were classified related to to the form of stool. The overlapping and nonoverlapping groups are defined by the patients who accompanied with functional disorder （FD） symptom or not. The survey on patients about character feature, mind feeling, sleep state, anxiety and depression were carried out. The control group consisting of 120 female no pregnant patients with IBS were selected at the same time. The IBS symptoms degree, classification and overlapping conditions of each term gestation and control group patients were analyzed and compared on the basis of statistics data. Results The morbidity and attack frequency of moderate and serious symptom of IBS reduced,while the incidence IBS-C,which reflect the disorder of colon motility, increased following gestation term extended （ P 〈 0.05 ）. The attack frequency of overlapping FD of the early and mid-term gestation subjects, the same as the contrast group,obviously increased in compared with later-term gestation. Conclusions There is obvious influence on the IBS attack in gestation women patients, the level of sex hormone which closed relate to the gestation plays significant role on the change of colon motility and function.