切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2022, Vol. 11 ›› Issue (04) : 303 -309. doi: 10.3877/cma.j.issn.2095-3224.2022.04.006

论著

功能性排便障碍患者合并焦虑、抑郁和躯体症状的调查
徐帅1, 宋笑天1, 杨斌1, 廉博1, 余鹏飞1, 冯向英1, 鲁瑶1, 姬丽娜1, 杨颖1, 康振华2, 李旭照3, 陈杰4, 赵青川1,()   
  1. 1. 710000 西安,空军军医大学第一附属医院消化外科
    2. 130000 长春,吉林大学第一医院结直肠肛门外科
    3. 750011 宁夏,西北民族大学第一附属医院普通外科
    4. 850007 拉萨,西藏军区总医院肛肠科
  • 收稿日期:2022-02-07 出版日期:2022-08-25
  • 通信作者: 赵青川
  • 基金资助:
    国家自然科学基金项目(82100680)

Investigation of anxiety, depression and somatic symptoms in patients with functional defecation disorders

Shuai Xu1, Xiaotian Song1, Bin Yang1, Bo Lian1, Pengfei Yu1, Xiangying Feng1, Yao Lu1, Li'na Ji1, Ying Yang1, Zhenhua Kang2, Xuzhao Li3, jie Chen4, Qingchuan Zhao1()   

  1. 1. Department of Digestive Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710000, China
    2. Department of Colorectal and Anal Surgery, the First Hospital of Jilin University, Changchun 130000, China
    3. Department of General Surgery, the First Affiliated Hospital of Northwest University for Nationalities, Ningxia 750011, China
    4. Department of Anorectal Surgery, General Hospital of Tibet Military Region, Lasa 850007, China
  • Received:2022-02-07 Published:2022-08-25
  • Corresponding author: Qingchuan Zhao
引用本文:

徐帅, 宋笑天, 杨斌, 廉博, 余鹏飞, 冯向英, 鲁瑶, 姬丽娜, 杨颖, 康振华, 李旭照, 陈杰, 赵青川. 功能性排便障碍患者合并焦虑、抑郁和躯体症状的调查[J/OL]. 中华结直肠疾病电子杂志, 2022, 11(04): 303-309.

Shuai Xu, Xiaotian Song, Bin Yang, Bo Lian, Pengfei Yu, Xiangying Feng, Yao Lu, Li'na Ji, Ying Yang, Zhenhua Kang, Xuzhao Li, jie Chen, Qingchuan Zhao. Investigation of anxiety, depression and somatic symptoms in patients with functional defecation disorders[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2022, 11(04): 303-309.

目的

了解功能性排便障碍患者合并焦虑、抑郁及躯体症状阳性率及其危险因素分析。

方法

选择2020年11月~2021年9月期间就诊于西京消化病院便秘专科门诊的功能性排便障碍患者86例,根据GAD-7、PHQ-9和PHQ-15量表计分,统计患者合并焦虑、抑郁及躯体症状的发生率,并采用Logistics回归分析其危险因素。

结果

入组患者86例,男性18例(20.9%),女性68例(79.1%),平均年龄(46.7±13.4)岁,中位病程7.5(3~15.3)年。焦虑的发生率80.2%,抑郁的发生率73.2%,躯体症状的发生率94.2%。单因素回归分析可见排便费力(χ2=10.489,P<0.05)和排便不尽感(χ2=9.389,P<0.05)与患者合并躯体症状相关。多因素回归分析显示排便不尽感是患者合并焦虑(OR=4.831,95%CI:1.364~17.117,P<0.05)、抑郁(OR=4.21495%CI:1.162~15.282,P<0.05)和躯体症状(OR=7.80995%CI:1.058~57.617,P<0.05)的独立危险因素。

结论

功能性排便障碍患者极易伴发焦虑、抑郁及躯体症状且患者具有排便不尽症状是合并焦虑、抑郁及躯体症状的独立危险因素。

Objective

To investigate the incidence and risk factors of anxiety, depression and somatic symptoms in patients with functional defecation disorders.

Methods

Eighty-six cases with functional defecation disorders were collected from November 2020 to September 2021 in the Department of Gastroenterology of Xijing Hospital. According to the scores of GAD-7, PHQ-9 and PHQ-15, to investigate the incidence of anxiety, depression and somatic symptom in patients combined with functional defecation disorders, and then the logistics regression was used to analyze the related risk factors.

Results

Among the 86 patients, eighteen (20.9%) were male and 68 (79.1%) were female, with an average age of (46.7±13.4)years and a median disease duration of 7.5 (3~15.3) years. The incidence of anxiety was 80.2%, depression was 73.2% and somatic symptom was 94.2%. Univariate regression analysis showed that defecation effort (χ2=10.489, P<0.05) and incomplete defecation (χ2=9.389, P<0.05) were significantly related to patients with somatic symptom. Multivariate regression analysis showed that incomplete defecation was an independent risk factor for patients with anxiety (OR=4.831, 95%CI: 1.364~17.117, P<0.05), depression (OR=4.214, 95%CI: 1.162~15.282, P<0.05) and somatic symptom (OR=7.809, 95%CI: 1.058~57.617, P<0.05).

Conclusion

Functional defecation disorders is easily combined with anxiety, depression, somatic symptom disorder and other systemic symptoms, and incomplete defecation is highly correlated with anxiety, depression and somatic symptoms in patients with functional defecation disorders.

表1 86例患者的基本资料
表2 患者焦虑、抑郁及躯体症状阳性率及严重程度
表3 21例手术患者焦虑、抑郁及躯体症状阳性率及严重程度
表4 根据PHQ-15量表统计患者全身多系统症状的发生率
表5 单因素及多因素Logistic回归分析易合并焦虑的影响因素(
xˉ
±s,例)
表6 单因素及多因素Logistic回归分析易合并抑郁的影响因素(
xˉ
±s,例)
表7 单因素及多因素Logistic回归分析易合并躯体症状阳性的影响因素(
xˉ
±s,例)
[1]
中华医学会消化病学分会胃肠动力学组,中华医学会消化病学分会功能性胃肠病协作组. 中国慢性便秘专家共识意见(2019,广州) [J]. 中华消化杂志, 2019, 39(9): 577-598.
[2]
Mody R, GuÉrin A, Fok B, et al. Prevalence and risk of developing comorbid conditions in patients with chronic constipation [J]. Curr Med Res Opin, 2014, 30(12): 2505-2513.
[3]
Li N, Jiang J, Feng X, et al. Long-term follow-up of the Jinling procedure for combined slow-transit constipation and obstructive defecation [J]. Dis Colon Rectum, 2013, 56(1): 103-112.
[4]
黄钢丁, 姜海行, 唐少波, 等. 排便障碍的功能性便秘患者精神心理因素的研究 [J]. 临床消化病杂志, 2019, 31(5): 308-311.
[5]
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire [J]. JAMA, 1999, 282(18): 1737-1744.
[6]
Swinson RP. The GAD-7 scale was accurate for diagnosing generalised anxiety disorder [J]. Evid Based Med, 2006, 11(6): 184.
[7]
Bharucha AE, Lacy BE. Mechanisms, evaluation, and management of chronic constipation [J]. Gastroenterology, 2020, 158(5): 1232-1249.e3.
[8]
Li X, Feng R, Wu H, et al. Psychological characteristics and GoNogo research of patients with functional constipation [J]. Medicine (Baltimore), 2016, 95(52): e5685.
[9]
刘巍, 刘晓红, 方秀才, 等. 北京地区门诊慢性便秘患者多中心流行病学调查[J]. 胃肠病学, 2010, 15(2): 95-98.
[10]
贾英田. 便秘患者的精神心理因素与中医体质类型的相关性分析[D]. 成都: 成都中医药大学, 2012.
[11]
樊文彬. 肛肠科功能性便秘患者群身心状况、生活质量的调查及优化治疗方案的临床研究[D]. 成都: 成都中医药大学, 2020.
[12]
吴嘉煖, 刘晓红, 刘巍, 等. 慢性便秘患者精神心理状况及生活质量调查——多中心临床调查[J]. 中国实用内科杂志, 2009, 29(3): 237-239.
[13]
Dykes S, Smilgin-humphreys S, Bass C. Chronic idiopathic constipation: a psychological enquiry [J]. Eur J Gastroenterol Hepatol, 2001, 13(1): 39-44.
[14]
田晓彤, 梁春丽, 俞华芳, 等. 肛门直肠测压技术与便秘患者排便障碍症状及分型的相关性研究[J]. 临床内科杂志, 2019, 36(3): 178-181.
[15]
韩明, 张伟, 周东红, 等. 慢性肛病人者情绪障碍的调查与多因素分析[J]. 中国疼痛医学杂志, 2017, 23(6): 473-475.
[16]
薛雅红, 丁曙晴, 丁义江, 等. 受试者工作曲线评价盆底表面肌电对功能性肛门直肠痛的诊断价值[J]. 世界华人消化杂志, 2014, 22(10): 1471-1474.
[1] 黄鸿初, 黄美容, 温丽红. 血液系统恶性肿瘤患者化疗后粒细胞缺乏感染的危险因素和风险预测模型[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 285-292.
[2] 张熙东, 贾贺杰, 冯锐, 李路亚, 乔永志, 郑颖. 急诊患者家属焦虑的影响因素[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 319-324.
[3] 罗文斌, 韩玮. 胰腺癌患者首次化疗后中重度骨髓抑制的相关危险因素分析及预测模型构建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 357-362.
[4] 李玲, 刘亚, 李培玲, 张秀敏, 李萍. 直肠癌患者术后肠道菌群的变化与抑郁症相关性研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 607-610.
[5] 贺斌, 马晋峰. 胃癌脾门淋巴结转移危险因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 694-699.
[6] 高金红, 陈玉梅, 郭韵. 基于King互动达标理论的心理疏导在腹腔镜肝癌切除术患者的应用效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 517-520.
[7] 林凯, 潘勇, 赵高平, 杨春. 造口还纳术后切口疝的危险因素分析与预防策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 634-638.
[8] 杨闯, 马雪. 腹壁疝术后感染的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 693-696.
[9] 杜晨阳, 王勇, 段鑫, 柯文杰, 石念, 武英翔, 罗文. 腹腔镜下食管裂孔疝修补术后吞咽困难的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 523-527.
[10] 周艳, 李盈, 周小兵, 程发辉, 何恒正. 不同类型补片联合Nissen 胃底折叠术修补食管裂孔疝的疗效及复发潜在危险因素[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 528-533.
[11] 司楠, 孙洪涛. 创伤性脑损伤后肾功能障碍危险因素的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 300-305.
[12] 赵小民, 杨军, 田巍巍. 枳术颗粒联合利那洛肽治疗便秘型肠易激综合征的临床研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 465-469.
[13] 白杰, 王唯一, 陈超, 王帆, 肖新如. 神经外科住培医师职业倦怠及影响因素研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 662-670.
[14] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[15] 李文哲, 王毅, 崔建, 郑启航, 王靖彦, 于湘友. 新疆维吾尔自治区重症患者急性肾功能异常的危险因素分析[J/OL]. 中华卫生应急电子杂志, 2024, 10(05): 269-276.
阅读次数
全文


摘要