| Objective: Through analyzing the basic situation,characteristics,main clinical manifestations,epidemiological characteristics of 105 IBS patients and comparing different treatment curative effect,to improve the level of awareness of the disease and the diagnosis,treatment,and provide help for clinical diagnosis and treatment of IBS.Methods: We adopted the method of questionnaire investigation and follow-up observation to collecting the clinical data of 105 IBS patients,who were conformed to the Rome III criteria for diagnosis and with complete medical records in the digestive department of first hospital affiliated to Dalian in December 2014-December 2015.Mainly including general data,the main clinical manifestations,abdominal imaging examination,endoscopy,concomitant disease and treatment outcome.And by comparing the curative effect of different treatments,and discusses the best treatment.Results: 1.There were 140 questionnaires collected,and 35 questionnaires were ruled out,which were not accord with the standard of the study,and remaining 105.Among 105 patients,there are 37 cases of men(35%),68 cases of women,(65%),the male to female ratio is 1:2.Onset age is from 23-78 years old,the average age is 57.1 ± 10.3 years old,peaks age of the illness is 50-69 years old,accounting for 73% of the whole people in the study.Subtypes: there are 42 cases of diarrhea type(40%);23 cases of constipation type(21.9%);9 cases of alternate type(8.6%);31 cases of unclassified type(29.5%).The course of the disease is from half a year to 30 years,And 38% are 1to 3 years.59 cases are retired(56.2%),8 cases are farmers(7.6),10 cases are workers(9.5%),12 cases are company employees(11.4%),7 cases are individuals(6.7%),4 cases are civil servants(3.8%),4 cases are teachers(3.8%),and 1 driver.88 people are urban population(83.8%),17 are the rural population(16.2%).25 cases with a primary culture(23.8%);46 cases with junior high school(43.8%);19 high school(18.1%);15 are university culture(14.3%);Income levels: 43 cases < 2000yuan/month(41%),55 cases with the income from 2000 to 5000 to 55(52.4%),6 people 5000 to 10000 for 6(5.7%),1people >10000yuan/month(1%).2.the major clinical manifestations:(1)abdominal symptoms: 11 cases with no abdominal pain and discomfort(10.5%),52 patients with abdominal pain(49.5%),28 cases with abdominal discomfort(26.7%),64 cases with abdominal distension(61%);42 cases with the symptoms of flatulence(40%).According to the area,31 patients with epigastric pain(29.5%).37 cases with periumbilical and abdominal pain(35.2%).20 cases with lower quadrant abdominal pain(19%),5 cases with abdominal pain or discomfort for all(4.8%).Nature of pain,41 cases are dull pain in patients with(39%);11 cases are colic(10.5%).The number of pain associated with eating cold and stimulating food is 32(30.5%).(2)Accompanying symptoms: 75 cases with upper gastrointestinal symptoms(acid reflux,heartburn,gas,etc.)(59.5%).7 cases with back pain(6.7%);9 cases with chest tightness and chest pain(8.6%);4 cases with urinary tract symptoms(3.8%);9 cases with dizziness,headache,fatigue(8.6%);5cases with loss of appetite(4.8%);2 people hot flashes(2%).(3)Nerve symptoms: There are 68 cases with neurological symptoms(64.8%),37 cases without neurological symptoms(35.2%).68 people are associated with anxiety and tension(64.8%),52 cases are associated with depression and depressed(49.5%),52 cases are associated with anxiety and depression(49.4%),60 people with sleep disorders(57.1%).3.Possible causes: such as staple food over-fine or too much dietary fiber,taste sweet or salty,like spicy;overeating high-protein diet;Love tea,drink;There are 21.9% of the patients with a history of food or drug allergies;39% of the patients with irregular eating;37.1% the toilet is irregular or disrupted;12.4% of patients with alcohol,tobacco,hobby;30.5% of the patients by eating cold causes symptoms and excitant food;30.5% of the number of people living environment noise;29.5% of patients and family relationship is nervous;45.7% of daily activity.4.the main symptoms: abdominal symptoms: 3 patients without abdominal symptoms(2.9%);70 cases with mild abdominal pain abdominal distension,mild influence quality of life(66.7%);32 cases with moderately and severe abdominal pain abdominal distension which seriously affect the quality of life(30.5%).12 cases with abnormal stool(11.4%),who are not diarrhea,constipation,23 cases with mild diarrhea,constipation(21.95%),70 cases with moderately severe diarrhea,constipation,(66.7%).Mental symptoms: 37 cases with no psychiatric symptoms(35.2%),11 cases are mild(10.5%),57 cases are moderately and severe(54.3%).5.Efficacy outcome:The three groups of patients are adviced to adjust in lifestyle,given psychological comfort and drug therapy(mainly for regulating intestinal flora,protect intestinal mucosa,adjusting intestinal drive,defecate and antidiarrheal therapy),patients with anxiety depression by psychosomatic consultations to conventional anti-anxiety treatment for depression.Three groups of effective abdominal pain remission rate is respectively:(94.3%,96.1%,83.9%),no difference between the three groups of efficient at 1 week,But group 1 and group 3 curative effect is better than that of group 2 in 4 and 8 weeks;Three groups of defecate is effective in relieving rate is respectively:(70.1%,82.6%,67.9%),no difference between the three groups of efficacy at 1 week,curative effect of group 2 is better than that of group 3 in 4 and 8 weeks;Accompanying symptoms effective response rate(98.6%,95.4%,66.6%),respectively,no difference between the three groups of efficient at 1 week,group 1 curative effect is superior to group 3 in 4 weeks,curative effect,no differences between group 1,group 2 group,and group 1,group 2 efficacy were significantly better than that of group 3 group 1 in 8 weeks.6.EQ – 5D and economics efficacy comparison: efficacy in improving the quality of life in patients is better in group 2 than group 1 and group 3.Cost-effectiveness analysis: group 1 with the highest total cost,but group 2 group 3 were similar.But group 2 obtain the highest utility the effectiveness,followed by group 1,which are far higher than that of group 3,group 2 with the lowest cost utility ratio,group 3 is the highest.So it can be seen that the titer in group 2 is the best.Conclusion: Most patients with IBS are women and between 50-69 years old,the subtype was diarrhea type.Main medical reasons are abdominal pain and alter of bowel movements.Severe abdominal pain are seen in alternate type patients,diarrhea and constipation patients are lighter.More than half of the patients with upper gastrointestinal symptoms and other systems.Some patients exist triggers that may cause disease and exacerbate symptoms,such as diet,living environment,interpersonal relationship,smoking,drinking,etc.And IBS patients have different level of mental abnormalities,to different degrees with lower quality of life.Patients with anxiety depression after treatment with anti anxiety depression,to improve the symptoms of abdominal symptoms,and spiritual aspects of the effective treatment group were higher than anti-anxiety not depression,and can significantly improve the quality of life,to obtain the maximum economic benefit. |
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