Koloski N A, Talley N J, Huskic S S, Boyce P M
Department of Medicine, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
Aliment Pharmacol Ther. 2003 Mar 15;17(6):841-51. doi: 10.1046/j.1365-2036.2003.01498.x.
The drivers of conventional and, especially, alternative health care use for irritable bowel syndrome and functional dyspepsia are not clear.
To determine the predictors of conventional and alternative health care use for irritable bowel syndrome and functional dyspepsia.
Two hundred and seven subjects with irritable bowel syndrome or functional dyspepsia, identified from a previous population survey, were included in the study. Individuals with irritable bowel syndrome/functional dyspepsia were defined as consulters (n = 103) if they had visited their doctor for gastrointestinal symptoms more than once in the past year. Controls (n = 100) did not report having any abdominal pain. Subjects were given structured interviews to assess the Diagnostic and Statistical Manual - version IV (DSM-IV) and International Classification of Disorders - version 10 (ICD-10) psychiatric diagnosis for anxiety, depression, somatization or any psychiatric diagnosis, aspects of health care use and symptom factors.
About one-half (n = 103, 49.8%) of community subjects with irritable bowel syndrome/functional dyspepsia had sought conventional care for gastrointestinal symptoms in the past 12 months. Lifetime rates for alternative health care use for gastrointestinal symptoms were 20.8% (n = 43). Independent predictors of conventional health care use were more frequent abdominal pain, greater interference of gastrointestinal symptoms with work and activities and a greater satisfaction with the physician-patient relationship. Being female independently predicted alternative health care use.
Psychological morbidity did not predict conventional or alternative health care use for gastrointestinal symptoms. Other factors were more important.
肠易激综合征和功能性消化不良患者使用传统医疗，尤其是替代医疗的驱动因素尚不清楚。
确定肠易激综合征和功能性消化不良患者使用传统医疗和替代医疗的预测因素。
从之前的一项人群调查中确定的207名肠易激综合征或功能性消化不良患者纳入本研究。如果肠易激综合征/功能性消化不良患者在过去一年中因胃肠道症状就诊超过一次，则被定义为咨询者（n = 103）。对照组（n = 100）未报告有任何腹痛。对受试者进行结构化访谈，以评估《精神疾病诊断与统计手册》第四版（DSM-IV）和《国际疾病分类》第十版（ICD-10）中关于焦虑、抑郁、躯体化或任何精神疾病诊断、医疗保健使用方面和症状因素。
在患有肠易激综合征/功能性消化不良的社区受试者中，约一半（n = 103，49.8%）在过去12个月中因胃肠道症状寻求过传统医疗。因胃肠道症状使用替代医疗的终生率为20.8%（n = 43）。使用传统医疗的独立预测因素是更频繁的腹痛、胃肠道症状对工作和活动的更大干扰以及对医患关系更高的满意度。女性是使用替代医疗的独立预测因素。
心理疾病并非胃肠道症状使用传统医疗或替代医疗的预测因素。其他因素更为重要。
