Huerta Ivonne, Bonder Allan, López Lizbeth, Ocampo María Aurora, Schmulson Max
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.
Rev Gastroenterol Mex. 2002 Jul-Sep;67(3):161-5.
Irritable bowel syndrome (IBS) can be explained by the interrelation of cognitive components such as illness behavior, emotional such as depression and anxiety, behavioral such as environmental stressors, and physiologic such as pain modulation alterations. The stress symptom rating (SSR) scale is being used in physiologic studies in IBS, but differences between IBS patients and healthy controls in the basal condition is unknown.
To determine the basal differences in the SSR-Spanish between IBS patients and controls, and between IBS patients according to bowel-habit predominance.
Forty consecutive IBS-Roma 1 patients [M: 28 (78%), F:8(22.2%), 42.6 +/- 2.7 years] and 36 healthy volunteers paired by gender and age [M: 28 (78%), F:8 (22.2%); 36.7 +/- 2.1 years] were included. IBS were classified as constipation, diarrhea, or alternating. All completed the SSR prior to the medical visit. Mean group values of the different SSR parameters were compared by ANOVA. A p < 0.05 was considered significant.
Compared with controls, IBS patients reported higher anxiety (p = 0.005), attention (p = 0.04) fatigue (p = 0.04), and lower arousal (p = 0.003). There were no differences in stress and anger either in IBS patients according to bowel-habit predominance.
Under basal conditions, there are differences in anxiety, weakness, attention, and arousal between IBS patients and controls that correspond to intrinsic characteristics of IBS independent of bowel-habit predominance. Higher anxiety is in agreement with psychological comorbidity, higher attention with hypervigilance, and fatigue and lower arousal with sleep disturbances known to be present in IBS. Absence of differences in stress and anger under basal conditions suggests that SSR-Spanish is a good instrument to evaluate response to stress during physiologic paradigms.
肠易激综合征（IBS）可通过疾病行为等认知成分、抑郁和焦虑等情绪、环境应激源等行为以及疼痛调节改变等生理因素之间的相互关系来解释。应激症状评定（SSR）量表正用于IBS的生理学研究，但IBS患者与健康对照在基础状态下的差异尚不清楚。
确定IBS患者与对照之间以及根据排便习惯优势的IBS患者之间在西班牙语版SSR上的基础差异。
纳入40例连续的IBS-Roma 1患者[男性：28例（78%），女性：8例（22.2%），42.6±2.7岁]和36名按性别和年龄匹配的健康志愿者[男性：28例（78%），女性：8例（22.2%）；36.7±2.1岁]。IBS分为便秘型、腹泻型或交替型。所有患者在就诊前均完成了SSR评定。通过方差分析比较不同SSR参数的组均值。p<0.05被认为具有统计学意义。
与对照组相比，IBS患者报告有更高的焦虑（p=0.005）、注意力（p=0.04）、疲劳（p=0.04）以及更低的觉醒水平（p=0.003）。根据排便习惯优势，IBS患者在应激和愤怒方面均无差异。
在基础状态下，IBS患者与对照在焦虑、虚弱、注意力和觉醒水平方面存在差异，这些差异与IBS的内在特征相关，且独立于排便习惯优势。更高的焦虑与心理共病相符，更高的注意力与过度警觉相符，疲劳和更低的觉醒水平与IBS中已知存在的睡眠障碍相符。基础状态下应激和愤怒无差异表明西班牙语版SSR是评估生理范式中应激反应的良好工具。
