心理社會因子與腸激躁症候群之相關探討

The Association between Psychosocial Factors and Irritable Bowel Syndrome

目的：腸激躁症候群在胃腸科、家醫科及基層醫療門診是相當常見的疾患之一，其可能會困擾患者的身心或生活品質，因此是值得我們去探討的問題。本研究旨在了解健檢個案之腸激躁症候群(IBS)之心理社會的相關因子。方法：從2007年5月至2008年4月間，以台中市某區域醫院自費全身健康檢查民眾為對象，選取年齡20歲以上，平均為 48.1±11.7歲，共收集有效樣本597人，其中男性佔有380人(63.7%)。本研究使用之量表包括基本資料、精神症狀（採簡式症狀量表之憂鬱及焦慮症狀）、社會因子及羅馬準則Ⅲ之腸激躁症候群之自陳式結構性問卷。結果：有腸激躁症候群者56人(9.4%)，女性佔12.9%、男性7.4%。女性(OR=2.9; 95% CI:1.4-6.0)、有生活或工作壓力(OR=3.8; 95%CI:1.8-7.9)、研究所以上學歷(OR=3.9; 95% CI:1.4-10.7)、有吸菸習慣(OR=2.3; 95% CI:1.1-4.9)、每日喝酒量越多(OR=1.01; 95%CI:1.001-1.02)、無運動者(OR=2.5; 95% CI:1.3-4.9)、焦慮程度越高(OR=2.1; 95% CI:1.4-3.3)者與腸激躁症候群有顯著相關。年齡越小者亦越會有腸激躁症候群之趨勢，但未達統計學上顯著差異。結論：本結果與國外非健檢的研究類似，心理社會因子與腸激躁症候群有關。

Background and objective: Irritable bowel syndrome (IBS) is a common disorder seen in outpatient departments of gastroenterology, family medicine and primary care. It may affect the subjects' mental status and quality of life. The aim of the present study was to investigate the association between psychosocial variables and IBS. Methods: A total of 597 participants including 380(63.7%) males and 217(36.3%) females (mean age 48.1±11.7 years) were enrolled from May 2007 to April 2008 from patients in a regional hospital at Taichung. They completed questionnaires comprised of psychosocial variables such as demographic data, lifestyle habits, the brief symptom rating scale (BSRS) for depression and anxiety and Rome Ⅲ criteria as the IBS diagnostic tool. Results: There were 56 subjects (9.4%) including 28 females (12.9%) and 28 males (7.4%) who met the criteria for IBS. Stepwise multiple logistic regression analysis revealed that being female (OR=2.9; 95% CI: 1.4-6.0), having life or work stress(OR=3.8; 95% CI: 1.8-7.9), having a post-graduate level of education (OR=3.9; 95% CI: 1.4-10.7), smoking (OR=2.3; 95% CI: 1.1-4.9), drinking alcohol every day (OR=1.01; 95% CI: 1.001-1.02), not exercising (OR=2.5; 95% CI: 1.3-4.9) and having higher BSRS-anxiety scores (OR=2.1; 95% CI: 1.4-3.3) were associated with IBS. IBS was more prevalent in younger subjects than in the elderly, but this did not reach statistical significance. Conclusion: Multiple psychosocial factors are associated with irritable bowel syndrome in this particular study population.