肠易激综合征患者生活质量对照研究

目的了解肠易激综合征(IBS)患者生活质量状况.方法应用SF-36健康普适量表对25例符合罗马Ⅱ诊断标准的IBS患者及性别、年龄相匹配的健康对照者进行调查,作生活质量比较研究.结果 IBS患者除了生理功能(PF)外,其它7个维度的生活质量平均积分均比健康对照组低(生理职能P＜0.05,余6个维度均P＜0.01);IBS患者生活质量下降和肠道症状并不相关.结论 IBS患者生活质量普遍低下,但并非肠道症状直接影响所致.     

行为疗法对肠易激综合征患者生活质量的影响

目的 探讨行为疗法对肠易激综合征(IBS)患者生活质量的影响.方法 60例IBS患者随机分为对照组和干预组(各30例),常规药物治疗,干预组加用行为疗法干预.于实验前及实验后6周末评估生活质量.结果 两组均完成治疗和问卷调查.干预组总有效率(100.0%)高于对照组(60.0%),干预组腹痛、腹胀、便秘、黏液便症状明显...     

行为疗法对肠易激综合征患者生活质量的影响

目的探讨行为疗法对肠易激综合征(IBS)患者生活质量的影响。方法 60例IBS患者随机分为对照组和干预组(各30例),常规药物治疗,干预组加用行为疗法干预。于实验前及实验后6周末评估生活质量。结果两组均完成治疗和问卷调查。干预组总有效率(100.0)高于对照组(60.0),干预组腹痛、腹胀、便秘、黏液便症状明显减轻,优于对照组,差异均有统计学意义(P<0.05,P<0.01)。结论行为疗法能有效改善IBS患者的临床症状,提高其生活质量。     

411例肠易激综合征患者生活质量状况调查

目的探讨肠易激综合征（IBS）患者的生活质量状况。方法在西安市2所综合医院选取连续的411例IBS患者，其SF-36量表中8个维度的得分以及生理功能总分和心理功能总分与430名健康对照者的得分相比较。结果IBS患者在SF-36量表所有8项维度的得分比健康对照者显著降低（P〈0．001），得分最低的维度是总体健康和情感职能，分别为33．5±16．9、40．8±25．1。IBS患者生理功能总分和心理功能总分也显著降低（P〈0．001）。结论IBS患者生活质量明显受损。分析结果有助于更好了解IBS对患者功能和健康的影响。     

对女性肠易激综合征患者进行健康教育的效果评价

[目的]IBS患者但尚无满意的治疗方法.本研究旨在评价对女性IBS患者进行健康教育的效果.[方法]采用自身对照研究,IBS-36量表对IBS患者进行相关生存质量(health-related QOL,HR-QoL)评分.对33例女性IBS患者进行积极的健康教育,评价基线为干预前2月的评分,评价终点为干预后3月的评分.[结果]共33例患者进入基线评价,31例患者完成健康教育全过程和干预后3月的评价.干预后IBS-36评分比干预前明显下降,(25.5±6.5)vs(16.6±5.9)分(P＜0.01).对腹痛和排便异常两个单项进行比较,干预后的评分也比干预前明显下降(分别3.6±1.3 vs 2.1±0.9和3.1±1.2 vs 1.3±1.1,两者P＜0.001).[结论]健康教育可在短期内缓解或消除女性IBS患者的心理障碍和躯体症状,使患者的健康相关生存质量明显改善.     

肠靶向催眠疗法对于改善肠易激综合征患者生活质量及临床疗效的意义

目的 探讨肠易激综合征(IBS)患者使用肠靶向催眠疗法的临床疗效及对生活质量的改善,为IBS的治疗提供依据.方法 筛选2009年5月至2012年2月期间我院收治的IBS患者89例,随机分为催眠治疗组45例和对照组44例,所有患者均根据其症状、体征予以对症药物治疗12周,在此基础上,催眠治疗组进行为期12周的肠靶向催眠治疗.比较2组治疗后临床症状、情绪、精力状态、应对方式、生活质量的变化情况及总体疗效的差异.结果 治疗后,催眠治疗组总有效率(95.6％)明显高于对照组(79.5％),差异有统计学意义(P＜0.05);催眠治疗组IBS生活质量调查问卷总分及5个维度的得分均明显高于对照组,差异均有统计学意义(P＜0.05);简明心境问卷中5个负性因子得分、特质应对方式问卷中的消极应对得分及临床症状评定量表的各项得分均较对照组降低,而精力和积极应对得分则明显高于对照组,差异均有统计学意义(P＜0.05).结论 肠靶向催眠疗法可有效提高IBS患者的临床疗效,明显降低负性情绪和不良应对方式,改善患者生活质量.     

肠易激综合征患者疾病认知情况调查

目的调查肠易激综合征（IBS）患者对疾病的认知情况。方法收集86例IBS患者进行问卷调查，然后根据各个调查问题进行患者数据汇总统计，并计算其占总例数的百分率。结果仅47．7％的患者听说过IBS，44．2％的患者认为IBS为肠道细菌感染性疾病。26．7％的患者认为IBS起源于急性胃肠炎。半数以上的患者认为IBS与心理因素．工作或生活压力、睡眠质量和食品有关。26．7％的患者认为诊断IBS需要长期反复进行结肠镜等检查，33．7％的患者认为仅使用药物就能治愈IBS。69．8％的患者认为IBS随着年龄增长会恶化，15．1％的患者认为IBS会发展为结肠癌。结论患者对IBS的知识了解有限，部分患者甚至观念错误。应加强对IBS患者的卫生知识宣教以提高IBS患者的生活质量。     

肠易激综合征患者实施护理干预效果评价分析

目的评估对肠易激综合征（IBS）患者实施综合护理干预的效果。方法将126例IBS患者随机分为对照组和干预组,各63例,对照组均给予常规护理,而干预组在常规护理的基础上增加综合护理干预的措施;采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活质量量表SF-36量表等对干预效果进行评价。结果干预组干预后的SAS评分、SDS评分明显低于对照组（P〈0．05）;干预组的一般生存质量良好率达85．71％,明显高于对照组的66．67％（P〈0．05）。结论IBS患者实施综合护理干预后,可有效减少患者的焦虑和抑郁情绪,提高患者生活质量。     

消化性溃疡患者生命质量测定量表研制及评价

目的 研制和评价慢性病患者生命质量测定量表体系之消化性溃疡量表(QLICD-PU).方法 用QLICD-PU对120名消化性溃疡患者住院治疗前后的生命质量进行测评,对量表信度、效度和反应度进行评价.结果 量表各条目与所属亚领域或领域的相关均大于该条目与其他亚领域或领域的相关,相关系数(r)>0.6;量表可以测出患者治疗前后各领域的生命质量变化,其中特异模块领域的标准化反应均数(SRM)=1.21,总量表SRM=1.10.结论 消化性溃疡患者生命质量测定量表(QLICD-PU)具有较好的信度、效度、反应度和临床可行性.     

Quality of life of patients with irritable bowel syndrome in Korea

Objective  The impact of irritable bowel syndrome (IBS) on HRQOL has been widely studied in the West. However, there are few data from Asian countries. The aim of this study was to assess the health-related quality of life (HRQOL) of patients suffering from IBS in Korea. Methods  Consecutive patients from six secondary and six tertiary medical centers in Korea were enrolled and completed self-administered questionnaires on sociodemographics and IBS-associated symptoms. HRQOL was assessed using the generic Short Form 36 (SF-36) and the disease-specific IBS-QOL questionnaires. Results  Of the 932 patients with abdominal pain and bowel symptoms, 664 IBS patients who fulfilled the Rome II criteria were analyzed. On all eight SF-36 scales, IBS patients had a significantly worse HRQOL than the general population (P < 0.01). The overall score for the IBS-QOL was 74.2. The health concern domain was most affected (mean score 64.2), and the sexual domain (mean score 86.7) was least affected in the IBS-QOL. Significant impairment of HRQOL was only observed in patients with severe symptoms both in the generic and specific HRQOL measurement, whereas patients with mild and moderate symptoms showed only mild impairment (P < 0.01). Female patients reported a significantly lower HRQOL than male patients (P < 0.05), but the difference was minimal. The IBS-QOL was significantly associated with female gender, total symptom score, self-reported symptom severity, and level of education in the multivariate analysis. Conclusions  IBS-related symptoms had a great effect on the HRQOL of Korean patients. These results and the considerable prevalence of IBS in Korea indicate that IBS has a substantial social impact in this country.     

Development and validation of a new health-related quality of life instrument for patients with sinusitis

Background and Objective: There are few validated measures of sinusitis-specific health-related quality of life (HRQL). This study used patient focus and pretesting groups followed by a prospective cohort study to develop and validate a HRQL instrument for patients with sinusitis. Methods: Instrument development involved a systematic literature review, use of expert input, and patient focus and pretesting groups. Patients were recruited from the practices of primary care providers and otolaryngologists. The derived survey instrument then underwent prospective testing in patients with acute sinusitis, chronic sinusitis, allergic rhinitis, and asymptomatic controls. Reduced item scales of the original instrument were developed for symptom frequency and bothersomeness. The psychometric properties of the survey instrument were evaluated for reliability, construct validity, responsiveness, and interpretability. Results: In the prospective study, 47 patients with acute sinusitis and 50 patients with chronic sinusitis were compared to 18 patients with allergic rhinitis and 60 patients without nasal symptoms. Forty-three (91.5) patients with acute sinusitis completed the questionnaire at baseline and at 1-month follow-up. Internal consistency was high for the symptom impact scale for acute and chronic sinusitis patients. The symptom frequency and especially bothersomeness scales had lower internal consistency particularly for acute sinusitis patients. Reproducibility among surgical patients retested prior to their procedure was good for each scale. A high degree of disciminant validity was demonstrated when comparing sinusitis patients to other groups, and a high degree of convergent validity was seen when the new measures were compared to other HRQL measures at baseline. Among patients with acute sinusitis, the responsiveness and interpretability of the symptom frequency, bothersomeness and impact scales were excellent. Conclusions: This study developed and validated a new sinusitis-specific HRQL instrument. The instrument included symptom frequency, bothersomeness and impact scales. It was shown to be valid in patients with acute and chronic sinusitis, and highly responsive and interpretable in acute sinusitis patients managed in the primary care setting.     

Management of patients with food intolerance in irritable bowel syndrome: the development and use of an exclusion diet

Food intolerance is an important cause of abdominal symptoms. As no objective tests are available to identify the foods concerned, diets are essential for the management of these patients. The fewer foods allowed in the diet, the greater is die chance of success. Our original studies of 182 patients between 1979 and 1982, using a diet of lamb, rice and pears, had resulted in a 67% success rate. The foods most commonly involved were wheat (60%), cows' milk (44%) and corn (44%). A less restrictive exclusion diet was developed from the results of this work, avoiding all those foods to which 20% or more of the patients had been intolerant. Of 253 patients (79%), 200 were able to complete 2 weeks on this diet and 100 (50%) were successful in controlling their symptoms. The exclusion diet was modified in the light of this experience and in a subsequent study of 129 patients, 96 (75%) were able to comply for 2 weeks, but only 39 (41%) improved on the basic diet. However, examination of the food diaries of these patients enabled the identification of less frequent food intolerances in 21 (22%) giving an overall success rate of 60 (63%). In this way, equally good results can be obtained using a nutritionally adequate exclusion diet and avoiding the difficulties of following a more rigorous elimination regime.     

肠易激综合征重叠功能性消化不良患者脑部痛觉区域研究

目的：探讨单纯肠易激综合征与肠易激综合征重叠功能性消化不良患者在直肠容积性刺激下脑部痛觉功能区域的变化差异。方法：连续收集共纳入30例入住医院诊断为单纯肠易激综合征患者（单纯组）及30例肠易激综合征重叠功能性消化不良患者（重叠组）作为病例观察对象,同时随机选择30例健康人作为正常对照组。所有受试者均行直肠容积性刺激,通过功能性磁共振（fMRI）分析直肠扩张50、100、150 mL容积情况下感觉阈值和痛觉评分。结果：单纯组与重叠组初始感觉、排便感觉及疼痛感觉阈值均低于对照组（P均〈0.05）。直肠注气100及150 mL时,单纯组与重叠组疼痛感觉明显高于对照组,差异有统计学意义（P〈0.05）;脑部疼痛区域主要集中于扣带回、岛叶、额前皮质及丘脑。直肠注气50、100、150 mL时,单纯组与重叠组疼痛兴奋面积及MRI信号强度均明显高于对照组,差异有统计学意义（P〈0.05）。结论：在直肠容积性刺激下,肠易激综合征患者存在感觉过敏,虽然其与功能性消化不良有症状的重叠,但重叠功能性消化不良并未影响其敏感性,且脑部痛觉功能区亦无明显叠加表现。     

The prevalence of irritable bowel syndrome in outpatients with bulimia nervosa

Objective:

This study examined the prevalence of irritable bowel syndrome (IBS) in patients with bulimia nervosa (BN), and the relationship between these disorders.

Method:

Sixty‐four participants with a diagnosis of BN or a related condition were recruited from an outpatient eating disorders service. Questionnaire and interview measures were used to assess bulimic symptoms and attitudes, IBS symptoms, anxiety and depression. Cases of IBS were identified using the Manning criteria.

Results:

There was a high prevalence of IBS in the patient group (68.8%), but IBS status was not predicted by any of the other variables measured. Patients who met criteria for IBS reported more frequent self‐induced vomiting than those who did not (U = 256.0, p = 0.038).

Discussion:

There is evidence of an high incidence of IBS in outpatients with BN, but the relationship between these conditions remains unclear. Future research should consider possible common risk factors. © 2011 by Wiley Periodicals, Inc.     

Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome

Background: Emerging evidence indicates that the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may result in symptoms in some patients with irritable bowel syndrome (IBS). The present study aimed to determine whether a low FODMAP diet is effective for symptom control in patients with IBS and to compare its effects with those of standard dietary advice based on the UK National Institute for Health and Clinical Excellence (NICE) guidelines. Methods: Consecutive patients with IBS who attended a follow‐up dietetic outpatient visit for dietary management of their symptoms were included. Questionnaires were completed for patients who received standard (n = 39) or low FODMAP dietary advice (n = 43). Data were recorded on symptom change and comparisons were made between groups. Results: In total, more patients in the low FODMAP group reported satisfaction with their symptom response (76%) compared to the standard group (54%, P = 0.038). Composite symptom score data showed better overall symptom response in the low FODMAP group (86%) compared to the standard group (49%, P < 0.001). Significantly more patients in the low FODMAP group compared to the standard group reported improvements in bloating (low FODMAP 82% versus standard 49%, P = 0.002), abdominal pain (low FODMAP 85% versus standard 61%, P = 0.023) and flatulence (low FODMAP 87% versus standard 50%, P = 0.001). Conclusions: A low FODMAP diet appears to be more effective than standard dietary advice for symptom control in IBS.