Influence of Different Diagnostic Standards on the Prevalence of Irritable Bowel Syndrome among Middle School Students in Areas Affected by Wenchuan Earthquake_West China Medical Journal

Authors：

ZHENG Shicheng ¹ , FU Wanchao ¹ , HE Ying ¹ , DONG Xiaowei ¹ , WANG Yiping ² , ZHANG Qiang. ³

1. Department of Gastroenterology, the First People’s Hospital of Longquanyi District, Chengdu, Sichuan 610100, P. R. China; 2. Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 3. Department of Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

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Keywords：

汶川地震灾区; 中学生; 肠易激综合征; 标准

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目的　调查汶川地震灾区中学生肠易激综合征（IBS）的患病情况，分析罗马Ⅱ和罗马Ⅲ诊断标准对该人群IBS患病率的影响。方法　在汶川地震后2年半和3年，分别用罗马Ⅱ和罗马Ⅲ标准制定IBS中学生问卷调查表对地震灾区和非地震灾区5所中学的中学生进行2次调查，分析比较IBS患病率的变化。结果　用罗马Ⅱ标准调查发现地震灾区中学生IBS患病率为23.6%；非地震灾区患病率为21.6%，二者比较无统计学意义（P=0.267）；用罗马Ⅲ标准调查发现地震灾区中学生IBS患病率为6.2%，非地震灾区患病率为4.6%，二者比较无统计学意义（P=0.139）。符合两种诊断标准的地震灾区IBS学生有10.3%，非地震灾区IBS学生有9.2%，两者差异无统计学意义（P＞0.05）。②支持两种诊断标准的症状方面，地震灾区IBS学生每天排便＞3次或每周排便＜3次等症状相比较有统计学意义（P＜0.001）。③按罗马Ⅲ标准，各亚型构成比IBS-C为30.4%，IBS-D为28.4%，IBS-M为8.8%，IBS-U为32.4%；按罗马Ⅱ标准，各亚型构成比为IBS-C为28.5%，IBS-D为47.7%，腹泻和便秘交替型为18.6%，罗马Ⅲ标准中的IBS-M和IBS-U合为一组与罗马Ⅱ标准中的腹泻和便秘交替型的构成比进行比较，二者有统计学意义（P＜0.001）。结论　罗马Ⅱ和罗马Ⅲ两种标准调查地震灾区中学生IBS患病率和分型存在着差异，但两种标准对地震灾区IBS患病率的影响是对等的，患病率和分型的不同是由两种标准的本身的差异造成，可能更接近罗马Ⅲ诊断标准。

Citation： ZHENG Shicheng,FU Wanchao,HE Ying,DONG Xiaowei,WANG Yiping,ZHANG Qiang.. Influence of Different Diagnostic Standards on the Prevalence of Irritable Bowel Syndrome among Middle School Students in Areas Affected by Wenchuan Earthquake. West China Medical Journal, 2012, 27(11): 1610-1613. doi: Copy

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12.	王睿, 郑仕诚, 张强, 等. 青少年焦虑情绪障碍筛查表在汶川地震灾区中学生应用的信效度评价[J]. 四川大学学报(医学版), 2012, 43(4): 562-565.
13.	陈志君, 高福音. 肠易激综合征罗马Ⅱ与罗马Ⅲ标准在临床应用中的比较研究[J]. 中国药物与临床, 2010, 10(11): 1270-1271.
14.	汪安江, 廖献花, 胡品津, 等. 罗马Ⅲ和罗马Ⅱ标准诊断肠易激综合征的比较[J]. 中华内科杂志, 2007, 46(8): 64-67.
15.	孙菁, 袁耀宗. 肠易激综合征: 罗马Ⅲ标准与我国共识意见解读[J]. 医学与哲学(临床决策论坛版), 2008, 29(6): 12-14.
16.	Engsbro AL, Simren M, Bytzer P. Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome Ⅲ classification[J]. Aliment Pharmacol Ther, 2012, 35(3): 350-359.
17.	Yao X, Yang YS, Cui LH, et al. Subtypes of irritable bowel syndrome on RomeⅢ criteria : a multi-center study[J]. J Gastroenterol Hepatol, 2011, 27(4):760-765.
18.	Ebling B, Jurcić D, Gmajnić R, et al. Anthropological, demographic and socioeconomic characteristics of irritable bowel syndrome[J]. Coll Antropol, 2011, 35(2): 513-521.
19.	Drossman DA, Chang L, Bellamy N, et al. Severity in irritable bowel syndrome: a Rome Foundation Working Team report[J]. Am J Gastroenterol, 2011, 106(10): 1749-1759.

1. 　Zhong L, Hou X. Pathophysiologic findings of irritable bowel syndrome in China[J]. J Neurogastroenterol Motil, 2012, 18(1): 19-33.
2. 　Hungin AP, Whorwell PJ, Tack J, et al. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects[J]. Aliment Pharmacol Ther, 2003, 17(5): 643-650.
3. 　Zhou H, Yao M, Cheng GY, et al. Prevalence and associated factors of functional gastrointestinal disorders and bowel habits in Chinese adolescents: a school-based study[J]. J Pediatr Gastroenterol Nutr, 2011, 53(2): 168-173.
4. 　袁帅, 张莉玲. 罗马Ⅲ标准在肠易激综合征诊断中的风险研究(附132例报告)[J]. 新医学, 2009, 40(6): 391-392.
5. 　Ersryd A, Posserud I, Abrahamsson H, et al. Subtyping the irritable bowel syndrome by predominant bowel habit: Rome Ⅱ versus Rome Ⅲ[J]. Aliment Pharmaeol Ther, 2007, 26(6): 953-961.
6. 　Sperber AD, Shvartzman P, Friger M, et al. A comparative reappraisal of the RomeⅡ and RomeⅢ diagnostic criteria:are we getting closer to the ‘true’ prevalence of irritable bowel syndrome? [J]. Eur J Gastroenterol Hepatol, 2007(19): 441-447.
7. 　胡品津, 方秀才. 肠易激综合征诊断和治疗[M]. 北京: 科学出版社, 2009: 47-48.
8. 　Drossman DA. RomeⅢ: the functional gastrointestinal disorders[M]. 3rd ed. McLean: Degnon Associates Inc, 2006: 1-26.
9. 　Zheng S, Fu W, Zhou J, et al. Prevalence and related factors of irritable bowel syndrome among middle-school students in areas affected by Wenchuan Earthquake: an epidemiological study[J]. J Clin Gastroenterol, 2012, 46(4): 345-346.
10. 　周惠清, 李定国, 宋艳艳, 等. 青少年肠易激综合征调查表的制定及考评[J]. 中华消化杂志, 2006, 26(2): 80-82.
11. 　姚敏, 陈燕萍, 周惠清, 等. 我国南方青少年肠易激综合征流行病学调查[J]. 临床儿科杂志, 2007, 25(10): 835-839.
12. 　王睿, 郑仕诚, 张强, 等. 青少年焦虑情绪障碍筛查表在汶川地震灾区中学生应用的信效度评价[J]. 四川大学学报(医学版), 2012, 43(4): 562-565.
13. 　陈志君, 高福音. 肠易激综合征罗马Ⅱ与罗马Ⅲ标准在临床应用中的比较研究[J]. 中国药物与临床, 2010, 10(11): 1270-1271.
14. 　汪安江, 廖献花, 胡品津, 等. 罗马Ⅲ和罗马Ⅱ标准诊断肠易激综合征的比较[J]. 中华内科杂志, 2007, 46(8): 64-67.
15. 　孙菁, 袁耀宗. 肠易激综合征: 罗马Ⅲ标准与我国共识意见解读[J]. 医学与哲学(临床决策论坛版), 2008, 29(6): 12-14.
16. 　Engsbro AL, Simren M, Bytzer P. Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome Ⅲ classification[J]. Aliment Pharmacol Ther, 2012, 35(3): 350-359.
17. 　Yao X, Yang YS, Cui LH, et al. Subtypes of irritable bowel syndrome on RomeⅢ criteria : a multi-center study[J]. J Gastroenterol Hepatol, 2011, 27(4):760-765.
18. 　Ebling B, Jurcić D, Gmajnić R, et al. Anthropological, demographic and socioeconomic characteristics of irritable bowel syndrome[J]. Coll Antropol, 2011, 35(2): 513-521.
19. 　Drossman DA, Chang L, Bellamy N, et al. Severity in irritable bowel syndrome: a Rome Foundation Working Team report[J]. Am J Gastroenterol, 2011, 106(10): 1749-1759.

West China Medical Journal

Influence of Different Diagnostic Standards on the Prevalence of Irritable Bowel Syndrome among Middle School Students in Areas Affected by Wenchuan Earthquake

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