腹泻型肠易激综合征主要证候分布与不同因素关系研究.docVIP

360例腹泻型肠易激综合征主要证候分布与不同因素关系的研究 作者：汪红兵,张声生,李振华,唐旭东,王新月,张福文,陈明,陶琳,唐博祥,朱培一,吴兵,李保双,宋秀江,刘敏,查波 【摘要】 目的 研究腹泻型肠易激综合征(IBS-D)流行病学特点以及主要证候与不同因素的关系。方法 采用临床流行病学调查方法,收集患者相关资料,以探讨IBS-D的主要证候特点及其与不同因素的关系。结果 IBS-D患者年龄集中在30～49岁之间；就诊人群的特殊嗜好依次为饮酒、吸烟、嗜辛辣、嗜咖啡等；情志不畅、精神紧张和饮食不节是其主要诱因；肝郁脾虚证所占比率最高(44.7%),不同年龄段、不同性别、不同职业和不同文化程度的证候分布无明显差异。结论 IBS-D患者实际就诊人数低于实际患病人数,精神心理因素是其重要内因,而饮食因素可能是其启动的重要外因；不同因素对证候分布无影响。 【关键词】 腹泻型肠易激综合征；中医证候；流行病学特点 　　Abstract：Objective To study the epidemiological characteristics of diarrhea-predominant irritable bowel syndrome (IBS-D) as well as the relationship between the main syndromes and different factors. Method The relevant information of patients were collected by clinical epidemiological method and the relationship between the main characteristics of the IBS-D syndromes and different factors was explored with the major syndromes as the key link. Result Most of the cases aged 30～49 years old. Special hobbies of patients followed by drinking, smoking, addicting spicy, addicting coffee and so on. Poor emotion, mental stress and diet were the main inducements. Liver stagnation and spleen deficiency has the highest percentage (44.7%). The distribution of syndromes in different ages, different genders, different occupations and different education had no significant difference. Conclusion The number of IBS-D hospital visiting-patients is lower than the actual number of illness people. Mental factors are important internal factors, and dietary factors may be an important external factor. Different factors have no effect on the distribution of syndromes. 　　Key words：IBS-D；TCM syndromes；epidemiological characteristics 　　肠易激综合征(irritable bowel syndrome,IBS)是一种以腹痛或腹部不适伴排便习惯改变为特征的功能性肠病,根据RomeⅢ标准可分为4个亚型,其中以腹泻型肠易激综合征(IBS-D)最为多见。IBS-D是中医治疗的特色优势病种之一,属于中医“泄泻”、“腹痛”范畴。既往研究显示,其主要证候涉及肝郁脾虚、脾虚湿阻、脾肾阳虚、脾胃湿热4种[1-2]。而进一步探讨这4种主要证候与年龄、性别、职业、文化程度等不同因素的关系,对IBS-D的中医临床流行病学研究有一定的意义。 　　1 资料与方法 　　1.1 研究对象 　　调查研究病例均来源于2007年5月－2009年3月的首都医科大学附属北京中医医院、中国中医科学院西苑医院、北京中医药大学东直门医院和北京通州区中医医院消化科门诊,共纳入360例