福建省青少年肠易激综合征的流行病学调查

目的分析城市中小学生肠易激综合征(IBS)的患病率、分布特征、致病的相关危险因素及焦虑性情绪障碍状况。方法采用多级整群随机抽样方法,对福建省两个地级市中4826名中小学生进行流行病学问卷调查。结果①校正后符合Manning及罗马Ⅱ诊断标准IBS的期间患病率分别是52．16％及17．10％,以高中生居多,男女患病率差异无统计学意义(P>0．05)。②Logistic回归分析揭示,年级、喜食辛辣或生冷食物、胃肠道感染、经常服用抗生素、遗传、经常因IBS症状而就诊、进食时吞咽困难、经常采用吞气来帮助终止打嗝、纳差、心情压抑11种因素为最具可能性的危险因素,其OR值均> 1。③4826名学生中有焦虑性情绪障碍倾向者占22．53％,男性17．84％,女性26．45％,两者差异有统计学意义(P<0．01)。④在儿童焦虑性情绪障碍筛查表(SCARED量表)5个领域的分值比较中,IBS学生高于非IBS学生,IBS就诊学生高于未就诊学生。结论①IBS是城市中小学生的常见病及多发病,患病率随年龄增长而上升;②不良饮食习惯、胃肠道感染、滥用抗生素、遗传及精神心理因素等可能是诱发城市中小学生IBS致病的相关危险因素;③焦虑性情绪障碍倾向发生率随年龄增长而上升。     

中国肠易激综合征流行病学调查现状分析

目的为了全面了解国内肠易激综合征(IBS)流行病学调查现状,特别是研究中的不足,以更好地指导今后流行病学研究,我们对国内IBS流行病学调查文献进行了分析。方法对2000年1月-2012年6月在国内期刊发表的有关IBS流行病学调查文献,以"肠易激综合征"和"流行病学"为关键词进行检索,并进行综合分析。结果 43篇有关IBS流行病学调查的文章发表在32种期刊杂志,调查范围涉及全国26个省市自治区,单个调查的样本量58～16727例,研究人群包括普通人群、特殊人群和IBS患者。72.1%研究采用了整群分层随机抽样的方法。有24项研究应用罗马Ⅱ标准,5项研究联合应用罗马Ⅱ和Manning标准,12项研究应用罗马Ⅲ标准。我国IBS患病率存在较大差异,流行病学研究诸多环节可能对调查结果产生影响。影响IBS发病和患病率的因素包括:心理、饮食、年龄、性别、胃肠道感染史、情绪压力、职业、服药史等。结论在我国,IBS的流行病学调查研究水平有待进一步提高。     

日照市居民肠易激综合征及功能性便秘的流行病学调查

目的 探讨日照市居民肠易激综合征(IBS)及功能性便秘的流行病学情况。方法适用整群随机抽样法抽取日照市居民2892入进行问卷调查，同时问卷普通内科及消化专科门诊连续病例各1006及495例。结果①日照市居民IBS的患病率为5．6％，普通内科门诊及消化专科门诊中IBS所占的比例分别为10．1％、34．3％。IBS女性病人病率显著高于男性，男女比例为1：1．51(P=0．027)。年龄对IBS的患病率无显著影响。IBS病人的就诊率为22，4％，男女就诊率差异无显著性。IBS各亚型构成比为：腹泻主导型占63．2％，便秘主导型占27、0％，其他型占9．8％。②日照市居民功能性便秘的患病率为3．0％。普通内科门诊及消化专科门诊中所占的比例分别为5．4％和4．8％。男性患病率显著低于女性，男女比例为1：1．77。随着年龄的增加，功能性便秘的患病率升高。社区人群中功能性便秘的就诊率为17．6％，男女差异无显著性。结论日照市居民IBS及功能性便秘的患病率低于国外报道水平。     

平顶山市居民肠易激综合征及功能性便秘的流行病学调查

目的探讨平顶山市居民肠易激综合征(IBS)及功能性便秘的流行病学情况.方法采用整群随机抽样法抽取平顶山市居民5 784人进行问卷调查,同时问卷普通内科及消化专科门诊连续病例各2 012及990例.结果 (1)平顶山市居民IBS的患病率为5.6%,普通内科门诊及消化专科门诊中IBS所占的比例分别为10.1%、34.3%.IBS女性病人发病率显著高于男性.年龄对IBS的患病率无显著影响.IBS各亚型构成比为:腹泻主导型占63.2%,便秘主导型占27.0%,其它型占9.8%.(2)平顶山市居民功能性便秘的患病率为3.0%.普通内科门诊及消化专科门诊中所占的比例分别为5.4%、4.8%.男性患病率显著低于女性.随着年龄的增加,功能性便秘患病率升高.结论平顶山市居民IBS及功能性便秘的患病率低于国外报道水平.     

广州市居民肠易激综合征及功能性便秘的流行病学调查

目的：探讨广州市居民肠易激综合征（IBS）及功能性便秘的流行病学情况。方法：采用整群随机抽样法抽取广州市居民2892人进行问卷调查,同时问卷普通内科及消化专科门诊连续病例各1006及495例。结果：（1）广州市居民IBS的患病率为5．6％,普通内科门诊及消化专科门诊中IBS所的比例分别为10．1％、34．3％,IBS女性患病率显著高于男性,男女比例为1：1．51（P＝0．27）,年龄对IBS的患病率无显著影响,IBS患者的就诊率为22．4％,男女就诊率差异无显著性。IBS各亚型构成比为：腹泻主导型占63．2％,便秘主导型占27．0％,男女就诊率鞠显著性,IBS各亚型构成比为：腹泻主导型占63．2％,便秘主导型占27．0％,其他型占9．8％,（2）广州市居民功能性便秘的患病率为3．0％,普通内科门诊及消化专科门诊中所占的比例分别为5．4％及4．8％。男性患病率显著低于女性,男女比例为1：1．877。随着年龄的增加,功能性便秘的患病率升高,社区人群中功能性便秘的就诊率为17．6％,男女差异无显著性。结论：广州市居民IBS及功能性便秘的患病率低于国外报道水平。     

枣庄地区肠易激综合征临床流行病学调查与分析

肠易激综合征(IBS)是一种常见的功能性胃肠病，近年来其发病似有增加趋势。为了解枣庄地区IBS的流行病学情况．2001年12月至2002年11月，我们采用问卷形式对3400例IBS患者进行了流行病学调查。现分析如下。     

某部海岛官兵肠易激综合征的流行病学调查

目的探讨海岛官兵肠易激综合征(IBS)的患病率及相关危险因素。方法采取整群、分层、随机抽样的方法对某部4 358名海岛官兵进行流行病学问卷调查。结果共调查4 358人,全部男性,平均年龄(31.57±10.95)岁,应答率为97%。校正后符合Manning标准IBS的标化患病率为8.67%,符合罗马Ⅲ诊断标准IBS的标化患病率为4.86%,患病率无年龄差别。Logistic回归分析提示,滥用抗生素、食物过敏史、胃肠道感染、心情压抑或生活事件消极应对方式、精神紧张、外界恶劣环境等为最具可能性的危险因素,其OR值均>1。结论 IBS是海岛官兵的常见病和多发病,应引起重视;滥用抗生素、食物过敏史、胃肠道感染、心情压抑或生活事件消极应对方式、精神紧张、外界恶劣环境等可能是诱发海岛官兵IBS致病的相关危险因素。     

上海市松江社区居民肠易激综合征流行病学调查

目的 探讨上海市松江地区常住成年社区居民符合罗马Ⅲ诊断标准的肠易激综合征(IBS)患者的患病率、亚型、分布特征及危险因素等.方法 采用多级、分层、整群随机抽样法,在2010年4月至5月间,对上海市松江区共45个社区居民进行面访式问卷调查.IBS诊断采用罗马Ⅲ标准,分型采用Bristol粪便形状分型量表.同时完成焦虑自评量表、抑郁自评量表及睡眠质量评估量表.结果 完成调查并回收问卷合格者7648份(名),有效率为90％.抽样人数占上海市松江区总人口数的1.62％.共检出符合罗马Ⅲ标准的IBS患者970例,其中男性492例,女性478例.标化后IBS患病率为13.1％,其中男性为13.8％,女性为12.7％,男女比例为1∶0.92,男女检出率差异无统计学意义(P＞0.05).患病率在18～29岁年龄段最高(18.2％,P=0.000).符合罗马Ⅲ分型标准中最多见的是未定型(45.3％),其次在男性以腹泻型(27.0％)多见,女性则以便秘型(19.5％)多见.在肥胖组(x2=4.046,P=0.044)、受高等教育组(x2=31.210,P=0.000)、脑力劳动组(x2=8.409,P=0.015)、未婚组(x2=26.933,P=0.000)、非腹部手术组(x2=5.894,P=0.015)IBS的患病率高于对照组.有胃肠道感染史、腹部手术史、服用抗生素及止痛药物史IBS的患病风险分别提高5.105、3.388、2.949及2.811倍(P=0.000).多因素分析显示较多地食用辛辣食物,IBS患病危险提高1.69倍(P=0.000),而高蛋白质饮食则是保护性因素(OR=0.900,P=0.000).焦虑(OR=2.452,P=0.000)及失眠(OR =2.452,P=0.000)同样是IBS患病的危险因素.结论IBS是上海市松江区社区成人的常见病和多发病.胃肠道感染史、腹部手术史、服用抗生素及止痛药物、嗜好辛辣食物、焦虑及失眠可能是IBS患病的危险因素.     

秦皇岛市城近郊区肠易激综合征的流行病学调查

用整群、分层、随机抽样的方法对秦皇岛市城近郊区中3个小区的常住居民进行面访式问卷调查.调查纳入850人,有效问卷840张(98.8%);符合RomeⅡ标准的肠易激综合征(IBS)症状患病率为4.6%,女性60岁以上组发病率较高;饮酒、受凉或进凉食、食物过敏、肠炎或痢疾史、生活事件、服NSAID史、消极应对方式等为最具有可能的危险因素.认为本地区居民中IBS患病率不低于北京等大城市;饮酒、食物过敏、服NSAID史等为最可能的高危因素.     

不同专业硕士研究生肠易激综合征的流行病学调查

背景：肠易激综合征（IBS）好发于中青年。西方国家的IBS患病率约为4．4％。22％，国内少见IBS流行病学调查报告，尤其是对大学生这一特殊群体。目的：了解不同专业硕士研究生的IBS患病率、症状特征和影响因素。方法：对华中科技大学190名非医学专业和170名医学专业硕士研究生进行问卷调查，内容包括：①胃肠道健康状况调查表，根据罗马Ⅱ标准诊断IBS；②抑郁自评量表（sDs）；③焦虑自评量表（SAS）。调查时间为2006年3-6月。结果：共获得有效问卷331份，有效率为91．9％。IBS总体患病率为15．4％（51/331），男女患病率差异无统计学意义（13.3％对17．6％，P=0．290），非医学专业组患病率显著高于医学专业组（19．7％对10．5％，P=0．022）。非医学专业组的腹痛、腹胀发生率及其持续时间和严重程度评分均显著高于医学专业组（P〈0．05），抑郁、焦虑评分亦显著高于医学专业组（P〈0．05）。logistic回归分析显示，抑郁情绪为可能的IBS危险因素（OR=365．17，R=0．010）。结论：非医学专业硕士研究生的IBS患病率、胃肠道症状发生情况和精神心理因素与医学专业生不同，非医学专业生更易患IBS。IBS相关症状及其发病与精神心理因素有关。     

Diagnosing irritable bowel syndrome

It is often possible to positively diagnose irritable bowel syndrome (IBS) based on a combination of multiple symptoms and their chronic nature. Both the Manning criteria and the ROME 1999 Consensus Working Party Diagnostic Criteria help in diagnosing IBS. It is important that, during the first visit, possible contributing factors, such as associated psychosocial stress or a history of mental, physical, or sexual abuse, are considered as part of the patient evaluation. Patients need to receive a clear explanation of the possible causes of symptoms, the benign nature of IBS, and the low likelihood of serious underlying disease. An interactive, positive physician-patient relationship has a beneficial effect on the course of IBS and may be associated with a decreased need for future health care visits.     

The irritable bowel syndrome

The irritable bowel syndrome (IBS) is a familiar problem in the clinic, but as a disease entity it remains ill defined. Much confusion has arisen in the past, because of the inappropriate inclusion within the category of IBS of almost any patient with unexplained abdominal discomfort. Recent work has established that IBS patients can be positively identified by a cluster of specific symptoms. With the use of these criteria, it seems likely that IBS patients suffer from a diffuse motor abnormality of the gut associated with visceral hypersensitivity; although there is no associated psychopathology, a central nervous system component to the disorder is possible. Better insight into IBS promises more effective management.     

Post-infectious irritable bowel syndrome

Post-infectious irritable bowel syndrome （PI-IBS） is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. Published studies have reported incidence of PI-IBS to range between 5% and 32%. The mechanisms underlying the development of PI-IBS are not fully understood, but are believed to include persistent sub-clinical inflammation, changes in intestinal permeability and alteration of gut flora. Individual studies have suggested that risk factors for PI-IBS include patients＇ demographics, psychological disorders and the severity of enteric illness. However, PI-IBS remains a diagnosis of exclusion with no specific disease markers and, to date, no definitive therapy exists. The prognosis of PI- IBS appears favorable with spontaneous and gradual resolution of symptoms in most patients.     

Post-infectious irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common disorder associated with abdominal pain or discomfort and altered bowel habits. The majority of patients describe an insidious onset of symptoms; however, a subset report a fairly precise time of onset following an attack of acute gastroenteritis. Typically, the potential acute infectious symptoms, such as fever and vomiting, resolve after several days, but abdominal discomfort, bloating, and diarrhea persist. Although the underlying mechanism of post-infectious IBS (PI-IBS) has not been established, ongoing inflammation appears to play a role, with an increase in serotonin-containing enterochromaffin cells, T lymphocytes, mast cells, proinflammatory cytokines, and intestinal permeability. Psychiatric comorbidities are less common in PI-IBS, compared with IBS patients in general; however, the prevalence of psychological disorders is still higher compared with that in the general population and is associated with a poorer prognosis. Overall, patients with PI-IBS have a slightly improved prognosis compared with those with IBS without an infectious onset.     

Post-infectious irritable bowel syndrome

Irritable bowel syndrome (IBS) affects 8% to 22% of the general population. Although patients describe an insidious onset of symptoms, including abdominal pain relieved with bowel movements, excessive intestinal gas, variable bowel habits, and abdominal bloating, a subgroup of individuals describe the onset of IBS symptoms following an episode of acute gastroenteritis, known as post-infectious IBS (PI-IBS). Several studies have demonstrated the development of IBS following infection. Risk factors for the development of PI-IBS are female sex and longer duration of initial illness. Although the underlying mechanism of PI-IBS is unclear, ongoing inflammation is clearly a factor in the pathogenesis. The underlying inflammatory process results in increased enterochromaffin cells, T-lymphocytes, intestinal permeability, colonic transit time, and a variety of immunologic abnormalities. PI-IBS patients tend to have a better prognosis than do those with idiopathic IBS, with resolution of symptoms within 5 to 6 years. Treatment is similar to that of idiopathic IBS.     

老年肠易激综合征

肠易激综合征是由腹部不适或腹痛伴排便异常组成的一组肠功能障碍性综合征,不能用任何结构异常或生化异常来解释。过去曾被称之谓“过敏性结肠”、“易激结肠”或“黏液性结肠炎”等,现规范统称之谓“肠易激综合征”（irritable bowel syndrome。IBS）^[1]。这是一种发病率高,时常影响终生的胃肠道疾病。流行病学研究提示年龄增长伴随IBS发病率减低（可能和老年人痛觉改变有关）,但1BS始终是老年人常见的胃肠道疾病。     

Postinfectious irritable bowel syndrome

A small but significant subgroup of patients with irritable bowel syndrome (IBS) report a sudden onset of their IBS symptoms after a bout of gastroenteritis. Population-based surveys show that although a history of neurotic and psychologic disorders, pain-related diseases, and gastroenteritis are all risk factors for developing IBS, gastroenteritis is the most potent. More toxigenic organisms increase the risk 11-fold, as does an initial illness lasting more than 3 weeks. Hypochondriasis and adverse life events double the risk for postinfective (PI)-IBS and may account for the increased proportion of women who develop this syndrome. PI-IBS is associated with modest increases in mucosal T lymphocytes and serotonin-containing enteroendocrine cells. Animal models and some preliminary human data suggest this leads to excessive serotonin release from the mucosa. Both the histologic changes and symptoms in humans may last for many years with only 40% recovering over a 6-year follow-up. Celiac disease, microscopic colitis, lactose intolerance, early stage Crohn's disease, and bile salt malabsorption should be excluded, as should colon cancer in those over the age of 45 years or in those with a positive family history. Treatment with Loperamide, low-fiber diets, and bile salt- binding therapy may help some patients. Serotonin antagonists are logical treatments but have yet to be evaluated.