The Study On Mechanisms Of Female Diarrhea Of Irritable Bowel Syndrome With Depression

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in clinic. The cardinal symptom is abdominal pain or discomfort accompanied with the change in bowel habit or in feces traits. At present, the specifical pathogenesis of IBS is unknown without the change in morphology and biochemistry. Most of IBS patients have metal disorder, especially anxiety and depression symptoms, which have cause an increasing clinical concern and affects the standard of the patient's life and prognosis. This research to investigate the effect of the level of estrogen and the change of visceral sensation by antidepressant treatment and its relation of IBS.Object and methods:All selected patients were accorded with Rome III diagnostic criteria for IBS and CCMD3 diagnostic criteria for depression, which eliminate organic disease and suicidal patients with severe depression.60 female IBS-D patients who selected and identified according to Rome III Diagnostic criteria were divided into two groups,30 cases in the study group (27 completed) and 30 cases in the control group (28 completed).The former were given antidepressant treatment,mental adjustment treatment and conventional treatment, the latter were give conventional treatment. All the cases received gastrointestinal symptoms score evaluating, HAMD scale evaluating, and HAMA scale evaluating, evaluating the regulation of regulation of visceral sensations and evaluating the level of estradiol before and after antidepressant treatment.All dates were processed by SPSS 17.0 statistical package. The result of counting date express by means±standard deviations, and the measurement date expressed by percentage. All statistics analysis was performed with T test. P values were computered, with statistical significance indicated by a value of P<0.05.Results:1. Result of whole symptom score:The study group and the control group were reduction in symptom score after the treatment of 8 weeks. The study group was significantly better than the control group. t=-4.998, P<0.05.there was a significant difference.2. Result of HAMD scale score:After the treatment of 8 weeks, the study group compared with the control group, HAMD scale score decreased significantly than that before treatment,t=-7.787, P<0.05, there was a significant difference.3. Results of sex hormone measurement:Before treatment, there were 9 cases study group which the sex hormone level was abnormal. After antidepressant treatment,6 cases came back to normal, the effective rate was 66.7 percent. Before treatment, the control group had 6 cases without the normal range. By conventional treatment, no one case came back to normal. There was a significant difference between two groups,t=3.954,P<0.05.4. The result of intolerance threshold:Two groups were no significant difference before treatment in intolerance threshold. After 8 weeks treatment,,there was a significant difference, t=5.592,P<0.05. The decline of visceral sensation was positively correlated with the level of estradiol (r=0.746, P<0.01).5. Result of HAMA scale score:Before treatment there were 20 cases of the study group had obvious anxiety. After antidepressant treatment 16 cases reduced obviously, the effective rate was 80 percent. While there were 19 cases in the control group, and only 3 cases were improvement after conventional treatment, the effective rate was 15.8 percent. The difference of the efficacy of two groups was significant, t=-7.348,P<0.05.Conclusions:1. Most of the female patients of IBS-D had different degree of depression and anxiety, and the conventional treatment is poor to them. There results tell us psychological factors play an important role in the pathogenesis of IBS.2. Most of the female patients of IBS-D have different standard of mood disorder and the abnormal level of sex hormone, it tell us that IBS has relationship with the increase of visceral sensitivity and the disorder of endocrine system.3. This experiment tells us using small dose antidepressant drug and mental adjustment treatment can significantly improve the physical and psychological symptoms, and can adjust the sex hormone level. It can improve the standard of peoples'life.