| Objective: To investigate the clinical characteristics and quality of life(QOL)in patients with irritable bowel syndrome(IBS)who meet Rome Ⅳ & Rome Ⅲ criteria,comparing to IBS patients who meet the Rome Ⅲ criteria only,and to analyze the factors which influence the QOL of IBS patients who meet the Rome Ⅳ criteria.Methods:From July 2017 to September 2018,a total of 4000 patients were investigated in the outpatient department of three tertiary hospitals including Bethune International Peace Hospital,the second hospital of Hebei Medical University and the affiliated hospital of Chengde Medical University,two hundred consecutive IBS patients were enrolled based on Rome Ⅲ or Rome Ⅳ criteria.The Symptom questionnaires were completed in face-to-face interview by well-trained investigators.The severity of symptoms was assessed using the IBS-SSS scale.Somatic symptoms were assessed using the PHQ-15 scale.The severity of anxiety and depression were assessed using the SAS/SDS scale.Sleep quality were assessed using the PSQI scale.The QOL were assessed by the SF-36 scale.Results: Patients were divided into two groups according to different diagnostic criteria: Rome Ⅳ & Rome Ⅲ criteria group(group A)and Rome Ⅲ criteria only group(group B).A total of 200 IBS patients were included in this study.Among them,97 subjects met the Rome Ⅳ criteria,199 met the Rome Ⅲ criteria and 96 patients met both of Rome Ⅲ and Rome Ⅳ criteria.Compared to Rome Ⅳ criteria group,the diagnostic rate was higher in Rome Ⅲ criteria group(P<0.05).Of the 97 individuals meeting the Rome Ⅳ criteria,one patient met Rome Ⅳ only and 96 met both of Rome Ⅲ and Rome Ⅳ criteria.Among 199 patients meeting the Rome Ⅲ criteria,103 patients met Rome Ⅲ only and 96 met both of the two criteria.Compared to those in group B,SF-36 total score and the scores of “physical function”,“physical role”,“bodily pain”,“vitality”,“social functioning”,“mental health” of 96 patients in group A were significantly reduced(P<0.05).Compared to those in group B,IBS-SSS score,the major intestinal symptoms score,defecation-related symptoms score and general intestinal symptoms score were lower in group A(P<0.05).Compared to the patients in group B,IBS patients in group A had more severe somatization symptoms,anxiety,depression and sleep disorders(P<0.05).The SF-36 total score and the score of physical function,role physical,general health and vitality of female were lower than those of male in Rome Ⅳ criteria group(P< 0.05).In Rome Ⅳ criteria group,IBS patients with urgency of defecation and evacuation of mucus had lower SF-36 score than those without,and the more severe the symptoms of abdominal pain,urgency of defecation and evacuation of mucus are,the lower the SF-36 score is(P< 0.05).In Rome Ⅳ criteria group,SF-36 score was negative correlation with IBS-SSS score(r=-0.319,P=0.001)and the severity of abdominal pain and the impact on life were the independent risk factors of lower SF-36 score(P<0.05).In addition,SF-36 score was negative correlated with the major intestinal symptoms score,defecation-related symptoms score and general intestinal symptoms(r=-0.206,P=0.043;r=-0.241,P=0.017,r=-0.266,P=0.008),the severity of urgency and mucus in defecation were the independent risk factors to predict lower SF-36 score(P<0.05).Moreover,there are negative correlations between PHQ-15 score,SAS/SDS score,PSQI score and SF-36 score(r=-0.370,P= 0.000;r=-0.475,P=0.000;r=-0.418,P=0.000;r=-0.517,P=0.000).The four dimensions of “bedtime”,“sleep time”,“hypnotic drugs” and “ daytime function” in PSQI scale were the independent risk factors to predict lower SF-36 score(P< 0.05).Conclusions: Compared to Rome Ⅳ criteria group,the diagnostic rate was higher in Rome Ⅲ criteria group(P<0.05).Compared to Rome Ⅲ criteria only group,IBS patients in Rome Ⅳ & Rome Ⅲ criteria group had more severe intestinal symptoms,somatic symptoms,anxiety,depression and sleep disorders(P<0.05),and the QOL were significantly reduced(P<0.05).The worse QOL was associated with gender,intestinal symptoms,somatic symptoms,anxiety and depression,and sleep disorders in Rome Ⅳ criteria group. |
