Sabate J-M, Veyrac M, Mion F, Siproudhis L, Ducrotte P, Zerbib F, Grimaud J-C, Dapoigny M, Dyard F, Coffin B
AP-HP, Hôpital Louis Mourier, Service d'Hépato-Gastroentérologie, Colombes, and INSERM, U-792, APHP, CHU Ambroise Paré, Montpellier, France.
Aliment Pharmacol Ther. 2008 Aug 15;28(4):484-90. doi: 10.1111/j.1365-2036.2008.03759.x. Epub 2008 Jun 9.
Relationships between pain threshold during rectal distension and both symptoms intensity and alteration in quality of life (QoL) in irritable bowel syndrome (IBS) patients have been poorly evaluated.
To evaluate relationships between rectal sensitivity, IBS symptom intensity and QoL in a multicentre prospective study.
Rectal threshold for moderate pain was measured during rectal distension in IBS patients (Rome II), while IBS symptoms intensity was assessed by a validated questionnaire and QoL by the Functional Digestive Disorder Quality of Life questionnaire.
Sixty-eight patients (44.2 +/- 12.7 years, 48 women) were included. The mean rectal distending volume for moderate pain was 127 +/- 35 mL while 45 patients (66%) had rectal hypersensitivity (pain threshold <140 mL). Rectal threshold was not significantly related either to overall IBS intensity score (r = -0.66, P = 0.62) or to its different components, or to FDDQL score (r = 0.30, P = 0.14). Among FDDQL domains, only anxiety (r = 0.30, P = 0.01) and coping (r = 0.31, P = 0.009) were significantly related with pain threshold.
In this study, two-thirds of IBS patients exhibited rectal hypersensitivity. No significant correlation was found between rectal threshold and either symptom intensity or alteration in QoL.
肠易激综合征(IBS)患者直肠扩张时的疼痛阈值与症状强度及生活质量(QoL)改变之间的关系尚未得到充分评估。
在一项多中心前瞻性研究中评估直肠敏感性、IBS症状强度与QoL之间的关系。
对IBS患者(罗马II标准)进行直肠扩张时测量中度疼痛的直肠阈值,同时通过一份经过验证的问卷评估IBS症状强度,并通过功能性消化紊乱生活质量问卷评估QoL。
纳入68例患者(44.2±12.7岁,48名女性)。中度疼痛时的平均直肠扩张容积为127±35 mL,45例患者(66%)存在直肠超敏反应(疼痛阈值<140 mL)。直肠阈值与IBS总体强度评分(r = -0.66,P = 0.62)、其不同组成部分或功能性消化紊乱生活质量问卷(FDDQL)评分(r = 0.30,P = 0.14)均无显著相关性。在FDDQL各领域中,仅焦虑(r = 0.30,P = 0.01)和应对(r = 0.31,P = 0.009)与疼痛阈值显著相关。
在本研究中,三分之二的IBS患者表现出直肠超敏反应。未发现直肠阈值与症状强度或QoL改变之间存在显著相关性。