乳糖摄入及精神心理因素对肠易激综合征患者胃肠道症状的影响
|
摘要
目的：
1.研究肠易激综合征(Irritable Bowel Syndrome, IBS)患者胃肠道症状的产生是否与乳糖摄入及精神心理因素有关；2.IBS患者和非胃肠道疾病患者生活质量的比较。
方法：
对442例IBS患者及119例无胃肠道症状的非胃肠道疾病患者进行问卷调查,问卷内容主要包括乳糖摄入量、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale, HADS)、近期生活事件评估量表(Recent Life Changes Questionnaire, RLCQ)、胃肠症状相关生活质量"B.E.S.T"评估问卷。
结果：
IBS患者乳制品乳糖摄入量较对照组低(p<0.01),而总乳糖和非乳制品乳糖摄入量两组间无明显差异(p>0.05)。IBS组主观乳糖不耐受发生率明显高于对照组(38.5% vs.6%,p<0.01)。IBS组焦虑、抑郁及应激性生活事件评分高于对照组,差异均有统计学意义(p<0.01),IBS组生活质量明显差于对照组(p<0.01)。
结论：
乳制品乳糖摄入及精神心理因素可能影响IBS患者症状的产生。IBS患者主观乳糖不耐受发生率显著高于非胃肠道疾病患者,进一步提示部分IBS患者症状可能与乳糖不耐受相关。IBS患者生活质量较非胃肠道疾病患者显著降低。
Objectives:
To assess impact of lactose intake、psychological factors and recent life stress on digestive symptoms in patients with Irritable bowel syndrome; to compare the quality of life correlates with the abdominal symptoms between patients with Irritable bowel syndrome and non-gastrointestinal disorders.
Methods:
A total of 442 patients with IBS and 119 non-gastrointestinal disorders were asked to complete questionnaires, including the Rome III questionnaire, Hospital Anxiety and Depression Scale (HADS), Recent Life Changes Questionnaire(RLCQ) and the "B.E.S.T" questionnaire which represents the quality of life correlates with the abdominal symptoms.
Results:
IBS patients had lower lactose intake in milk product than controls (p<0.01), but no significant differences between total lactose intake and lactose intake in non-milk product (p>0.05).There are higher incidence of Subjective lactose intolerance (SLI) in IBS patients than controls. IBS patients had a higher score of HA DS, RLCQ and lower score of the "B.E.S.T" questionnaire which represents the quality of life correlates with the abdominal symptoms than controls.
Conclusion:
The intake of lactose in milk product and psychological factors may be the risk factors on digestive symptoms in patients with IBS. The higher incidence of Subjective lactose intolerance in IBS patients than controls indicates that abdominal symptoms in IBS patients may be caused by the ingestion of lactose, which causes lactose intolerance. Compared with the non-GI controls, the quality of life impairment is more significant in IBS patients.
1.研究肠易激综合征(Irritable Bowel Syndrome, IBS)患者胃肠道症状的产生是否与乳糖摄入及精神心理因素有关；2.IBS患者和非胃肠道疾病患者生活质量的比较。
方法：
对442例IBS患者及119例无胃肠道症状的非胃肠道疾病患者进行问卷调查,问卷内容主要包括乳糖摄入量、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale, HADS)、近期生活事件评估量表(Recent Life Changes Questionnaire, RLCQ)、胃肠症状相关生活质量"B.E.S.T"评估问卷。
结果：
IBS患者乳制品乳糖摄入量较对照组低(p<0.01),而总乳糖和非乳制品乳糖摄入量两组间无明显差异(p>0.05)。IBS组主观乳糖不耐受发生率明显高于对照组(38.5% vs.6%,p<0.01)。IBS组焦虑、抑郁及应激性生活事件评分高于对照组,差异均有统计学意义(p<0.01),IBS组生活质量明显差于对照组(p<0.01)。
结论：
乳制品乳糖摄入及精神心理因素可能影响IBS患者症状的产生。IBS患者主观乳糖不耐受发生率显著高于非胃肠道疾病患者,进一步提示部分IBS患者症状可能与乳糖不耐受相关。IBS患者生活质量较非胃肠道疾病患者显著降低。
Objectives:
To assess impact of lactose intake、psychological factors and recent life stress on digestive symptoms in patients with Irritable bowel syndrome; to compare the quality of life correlates with the abdominal symptoms between patients with Irritable bowel syndrome and non-gastrointestinal disorders.
Methods:
A total of 442 patients with IBS and 119 non-gastrointestinal disorders were asked to complete questionnaires, including the Rome III questionnaire, Hospital Anxiety and Depression Scale (HADS), Recent Life Changes Questionnaire(RLCQ) and the "B.E.S.T" questionnaire which represents the quality of life correlates with the abdominal symptoms.
Results:
IBS patients had lower lactose intake in milk product than controls (p<0.01), but no significant differences between total lactose intake and lactose intake in non-milk product (p>0.05).There are higher incidence of Subjective lactose intolerance (SLI) in IBS patients than controls. IBS patients had a higher score of HA DS, RLCQ and lower score of the "B.E.S.T" questionnaire which represents the quality of life correlates with the abdominal symptoms than controls.
Conclusion:
The intake of lactose in milk product and psychological factors may be the risk factors on digestive symptoms in patients with IBS. The higher incidence of Subjective lactose intolerance in IBS patients than controls indicates that abdominal symptoms in IBS patients may be caused by the ingestion of lactose, which causes lactose intolerance. Compared with the non-GI controls, the quality of life impairment is more significant in IBS patients.
引文
[1]Saito YA, Schoenfeld P, Locke GRI. The epidemiology of irritable bowel syndrome in North America:A systemic review. Am J Gastroenterol,2002,97: 1910-5.
[2]Gwee, K. A. Irritable bowel syndrome in developing countries--a disorder of civilization or colonization? Neurogastroenterol Motil,2005,17:317-24.
[3]Longstreth, G. F. Definition and classification of irritable bowel syndrome: current consensus and controversies. Gastroenterol Clin North Am,2005,34: 173-87.
[4]Schmulson, M., O. Ortiz, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City. Dig Dis,2006,24:342-7.
[5]Chang FY, Lu CL. Irritable bowel syndrome in the 21st century:Perspectives from Asia or South-east Asia. J Gastroenterol Hepatol,2007,22:4-12.
[6]Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of Irritable bowel syndrome in Norway. Scand J Gastroenterol,2006,41:650-6.
[7]Celebi S, Acik Y, Deveci SE, et al. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol,2004,19:738-43.
[8]Makharia, G. K., A. K. Verma, et al. Prevalence of irritable bowel syndrome:a community based study from northern India. J Neurogastroenterol Motil,2011, 17(1):82-7.
[9]潘国宗,鲁素彩,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机的调查.中华流行病学杂志,2000,21：26-9.
[10]李定国,周惠清,等.全国城市中小学生肠易激综合征现况调查.中华内科杂志,2007,46：99-102.
[11]沈蕾,孔浩,等.不同专业硕士研究生肠易激综合征的流行病学调查.胃肠病 学,2007,12：14-8.
[12]Dai N, Cong Y, Yuan H. Prevalence of irritable bowel syndrome among undergraduates in Southeast China. Digestive and Liver Disease,2008,40: 418-24.
[13]Dong, Y. Y., X. L. Zuo, et al. Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome III criteria." World J Gastroenterol,2010,16(33):4221-6.
[14]Nanda R, James R, Smith H, Dudley CR, Jewell DP. Food intolerance and the irritable bowel syndrome. Gut,1989,30:1099-104.
[15]Vesa, T. H., P. Marteau, et al. Lactose intolerance. J Am Coll Nutr,2000,19(2 Suppl):165S-175S.
[16]Hovde, O. and P. G. Farup A comparison of diagnostic tests for lactose malabsorption--which one is the best? BMC Gastroenterol,2009,9:82..
[17]Yang Y, He M, Cui H, Bian L, Wang Z. The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Chin Med J(Engl), 2000,113 (12):1129-32.
[18]Montalto, M., V. Curigliano, et al. Management and treatment of lactose malabsorption. World J Gastroenterol,2006,12(2):187-91.
[19]Suarez FL, Savaiano DA, Levitt MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self- reported lactose intolerance. NEarlJMed,1995,333:1-4.
[20]Gupta, D., U. C. Ghoshal, et al. Lactose intolerance in patients with irritable bowel syndrome from northern India:a case-control study. J Gastroenterol Hepatol,2007,22(12):2261-5.
[21]Farup, P. G., K. W. Monsbakken, et al. Lactose malabsorption in a population with irritable bowel syndrome:prevalence and symptoms. A case-control study. Scand J Gastroenterol,2004,39(7):645-9.
[22]Saberi-Firoozi, M., F. Khademolhosseini, et al. Subjective lactose intolerance in apparently healthy adults in southern Iran:Is it related to irritable bowel syndrome? Indian J Med Sci,2007,61(11):591-7.
[23]Vesa, T. H., L. M. Seppo, et al. Role of irritable bowel syndrome in subjective lactose intolerance. Am J Clin Nutr,1998,67(4):710-5.
[24]Tracy J.Parker,Jenny T.Woolner, et al. Irritable bowel syndrome:is the search for lactose intolerance justified? Eur J Gastroenterol Hepatol,2001,13:219-225.
[25]Gralnek, I. M., R. D. Hays, et al. Racial differences in the impact of irritable bowel syndrome on health-related quality of life. J Clin Gastroenterol,2004, 38(9):782-9.
[26]Chang L, Talley N, Thompson WG, Whitehead WE. Rome III:The Functional Gastrointestinal Disorders:The Rome Foundation,2006.
[27]Brennan MR, Spiegel T, Naliboff B, Mayer E, Bolus R, Chang L. Development and Initial Validation of a Concise Point-of-Care Severity Index in irritable bowel syndrome:The"B.E.S.T"Questionnaire. Gastroenterology,2008, DDW abstract.
[28]Masuda, M, T. H. Holmes. The Social Readjustment Rating Scale:a cross-cultural study of Japanese and Americans." J Psychosom Res,1967,11(2):227-37.
[29]Rahe, R. H. Epidemiological studies of life change and illness. Int J Psychiatry Med,1975,6(1-2):133-46.
[30]Miller, M. A, R. H. Rahe. Life changes scaling for the 1990s. J Psychosom Res, 1997,43(3):279-92.
[31]Bjelland, I., A. A. Dahl, et al. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res,2002,52(2): 69-77.
[32]Zigmond, A. S, R. P. Snaith. The hospital anxiety and depression scale. Acta Psychiatr Scand,1983,67(6):361-70.
[33]Herrmann, C. International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. J Psychosom Res,1997,42(1):17-41.
[34]杨月欣编著.中国食物成分表(第二册).北京大学医学出版社.2004.
[35]金海玲,周德平.肠易激综合征患者的心理评估.世界华人消化杂志,1999,7(7)：628.
[36]李云桥,候晓华.心理因素与肠易激综合征.胃肠病学和肝病学杂志,2002,11(4)：326-329.
[37]Lee, M. F., R. M. Russell, et al. Total intestinal lactase and sucrase activities are reduced in aged rats. J Nutr,1997),127(7):1382-7.
[38]Bohmer, C. J. and H. A. Tuynman The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome:a 5-year follow-up study. Eur J Gastroenterol Hepatol,2001,13(8): 941-4.
[39]Bohmer, C. J. and H. A. Tuynman The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol,1996, 8(10):1013-6.
[40]Bozzani, A., R. Penagini, et al. Lactose malabsorption and intolerance in Italians. Clinical implications. Dig Dis Sci,1986,31(12):1313-6.
[41]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[42]Weinryb, R. M., E. Osterberg, et al. Psychological factors in irritable bowel syndrome:a population-based study of patients, non-patients and controls. Scand J Gastroenterol,2003,38(5):503-10.
[43]Halder, S. L., J. McBeth, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol,2002,31 (6):1219-25; discussion 1225-6.
[44]Koloski, N. A., N. J. Talley, et al. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study. Am J Gastroenterol,2003,98(4):789-97.
[45]Cruz Ruiz, M. A., R. B. Ortiz Herrera, et al. Association of depression and anxiety in patients with irritable bowel syndrome. Rev Gastroenterol Mex,2007, 72(1):29-33.
[46]Thijssen, A. Y., D. M. Jonkers, et al. Dysfunctional cognitions, anxiety and depression in irritable bowel syndrome. J Clin Gastroenterol,2010,44(10): e236-41.
[47]Gulewitsch, M. D., P. Enck, et al. Irritable bowel syndrome symptoms among German students:prevalence, characteristics, and associations to somatic complaints, sleep, quality of life, and childhood abdominal pain. Eur J Gastroenterol Hepatol,2011,23(4):311-6.
[48]Grundmann, O. and S. L. Yoon Irritable bowel syndrome:epidemiology, diagnosis and treatment:an update for health-care practitioners. J Gastroenterol Hepatol,2010,25(4):691-9.
[49]熊守礼,陈旻湖,等.肠易激综合征患者生存质量的评价.中华内科杂志,2004,43(5)：356-9.
[1]Drossman, D. A. The Rome Foundation and Rome Ⅲ. Neurogastroenterol Motil,2007,19(10):783-6.
[2]Talley, N. J. and R. Spiller Irritable bowel syndrome:a little understood organic bowel disease? Lancet,2002,360(9332):555-64.
[3]Chang L, Talley N, Thompson WG, Whitehead WE. Rome Ⅲ:The Functional Gastrointestinal Disorders:The Rome Foundation,2006.
[4]Shaw, A. D. and G. J. Davies Lactose intolerance:problems in diagnosis and treatment. J Clin Gastroenterol,1999,28(3):208-16.
[5]Saito YA, Schoenfeld P, Locke GRI. The epidemiology of irritable bowel syndrome in North America:A systemic review. Am J Gastroenterol,2002,97: 1910-5.
[6]Gwee, K. A. Irritable bowel syndrome in developing countries--a disorder of civilization or colonization?" Neurogastroenterol Motil,2005,17:317-24.
[7]Longstreth, G. F. Definition and classification of irritable bowel syndrome: current consensus and controversies. Gastroenterol Clin North Am,2005,34: 173-87.
[8]Schmulson, M., O. Ortiz, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City. Dig Dis,2006,24:342-7.
[9]Chang FY, Lu CL. Irritable bowel syndrome in the 21st century:Perspectives from Asia or South-east Asia. J Gastroenterol Hepatol,2007,22:4-12.
[10]Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of Irritable bowel syndrome in Norway. Scand J Gastroenterol,2006,41:650-6.
[11]Celebi S, Acik Y, Deveci SE, et al. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol,2004,19:738-43.
[12]Makharia, G. K., A. K. Verma, et al. Prevalence of irritable bowel syndrome:a community based study from northern India. J Neurogastroenterol Motil,2011, 17(1):82-7.
[13]潘国宗,鲁素彩,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机的调查.中华流行病学杂志,2000,21：26-9.
[14]熊守礼,陈旻湖,等.广东省社区人群肠易激综合征的流行病学研究.中华医学杂志,2004,84：278-81.
[15]Dai N, Cong Y, Yuan H. Prevalence of irritable bowel syndrome among undergraduates in Southeast China. Digestive and Liver Disease,2008,40: 418-24.
[16]Dong, Y. Y., X. L. Zuo, et al. Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome Ⅲ criteria." World J Gastroenterol,2010,16(33):4221-6.
[17]Poulter, M., E. Hollox, et al. The causal element for the lactase persistence/non-persistence polymorphism is located in a 1 Mb region of linkage disequilibrium in Europeans. Ann Hum Genet,2003,67(Pt 4):298-311.
[18]Sahi, T. Genetics and epidemiology of adult-type hypolactasia. Scand J Gastroenterol Suppl,1994,202:7-20.
[19]NandaR, James R, Smith H, Dudley CR, Jewell DP. Food intolerance and the irritable bowel syndrome. Gut,1989,30:1099-104.
[20]Bozzani, A., R. Penagini, et al. Lactose malabsorption and intolerance in Italians. Clinical implications. Dig Dis Sci,1986,31(12):1313-6.
[21]Bohmer, C. J. and H. A. Tuynman The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome:a 5-year follow-up study. Eur J Gastroenterol Hepatol,2001,13(8): 941-4.
[22]Bohmer, C. J. and H. A. Tuynman The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol,1996, 8(10):1013-6.
[23]Matthews, S. B., J. P. Waud, et al. Systemic lactose intolerance:a new perspective on an old problem. Postgrad Med J,2005,81(953):167-73.
[24]Tracy J.Parker,Jenny T.Woolner, et al. Irritable bowel syndrome:is the search for lactose intolerance justified? Eur J Gastroenterol Hepatol,2001,13:219-225.
[25]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[26]Weinryb, R. M., E. Osterberg, et al. Psychological factors in irritable bowel syndrome:a population-based study of patients, non-patients and controls. Scand J Gastroenterol,2003,38(5):503-10.
[27]Halder, S. L., J. McBeth, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol,2002,31(6):1219-25; discussion 1225-6.
[28]Koloski, N. A., N. J. Talley, et al. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study. Am J Gastroenterol,2003,98(4):789-97.
[29]Cruz Ruiz, M. A., R. B. Ortiz Herrera, et al. Association of depression and anxiety in patients with irritable bowel syndrome. Rev Gastroenterol Mex,2007, 72(1):29-33.
[30]Asahina, S., K. Hasegawa, et al. Depression in patients of irritable bowel syndrome. Nippon Rinsho,2006,64(8):1527-31.
[31]Thijssen, A. Y., D. M. Jonkers, et al. Dysfunctional cognitions, anxiety and depression in irritable bowel syndrome. J Clin Gastroenterol,2010,44(10): e236-41.
[32]Afsar, B., R. Elsurer, et al. Irritable bowel syndrome in haemodialysis: Prevalence, link with quality of life and depression. Nephrology (Carlton),2010, 15(2):197-202.
[33]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[34]Xiong, L. S., M. H. Chen, et al. A population-based epidemiologic study of irritable bowel syndrome in South China:stratified randomized study by cluster sampling. Aliment Pharmacol Ther,2004,19(11):1217-24.
[35]Tabas, G., M. Beaves, et al. Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet:a double-blind, placebo-controlled trial. Am J Gastroenterol,2004,99(5):914-20.
[36]Vahedi, H., S. Merat, et al. Clinical trial:the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 2008,27(8):678-84.
[37]Talley, N. J., J. E. Kellow, et al. Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome:a double-blind, randomized, placebo-controlled trial. Dig Dis Sci,2008,53(1):108-15.
[2]Gwee, K. A. Irritable bowel syndrome in developing countries--a disorder of civilization or colonization? Neurogastroenterol Motil,2005,17:317-24.
[3]Longstreth, G. F. Definition and classification of irritable bowel syndrome: current consensus and controversies. Gastroenterol Clin North Am,2005,34: 173-87.
[4]Schmulson, M., O. Ortiz, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City. Dig Dis,2006,24:342-7.
[5]Chang FY, Lu CL. Irritable bowel syndrome in the 21st century:Perspectives from Asia or South-east Asia. J Gastroenterol Hepatol,2007,22:4-12.
[6]Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of Irritable bowel syndrome in Norway. Scand J Gastroenterol,2006,41:650-6.
[7]Celebi S, Acik Y, Deveci SE, et al. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol,2004,19:738-43.
[8]Makharia, G. K., A. K. Verma, et al. Prevalence of irritable bowel syndrome:a community based study from northern India. J Neurogastroenterol Motil,2011, 17(1):82-7.
[9]潘国宗,鲁素彩,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机的调查.中华流行病学杂志,2000,21：26-9.
[10]李定国,周惠清,等.全国城市中小学生肠易激综合征现况调查.中华内科杂志,2007,46：99-102.
[11]沈蕾,孔浩,等.不同专业硕士研究生肠易激综合征的流行病学调查.胃肠病 学,2007,12：14-8.
[12]Dai N, Cong Y, Yuan H. Prevalence of irritable bowel syndrome among undergraduates in Southeast China. Digestive and Liver Disease,2008,40: 418-24.
[13]Dong, Y. Y., X. L. Zuo, et al. Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome III criteria." World J Gastroenterol,2010,16(33):4221-6.
[14]Nanda R, James R, Smith H, Dudley CR, Jewell DP. Food intolerance and the irritable bowel syndrome. Gut,1989,30:1099-104.
[15]Vesa, T. H., P. Marteau, et al. Lactose intolerance. J Am Coll Nutr,2000,19(2 Suppl):165S-175S.
[16]Hovde, O. and P. G. Farup A comparison of diagnostic tests for lactose malabsorption--which one is the best? BMC Gastroenterol,2009,9:82..
[17]Yang Y, He M, Cui H, Bian L, Wang Z. The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Chin Med J(Engl), 2000,113 (12):1129-32.
[18]Montalto, M., V. Curigliano, et al. Management and treatment of lactose malabsorption. World J Gastroenterol,2006,12(2):187-91.
[19]Suarez FL, Savaiano DA, Levitt MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self- reported lactose intolerance. NEarlJMed,1995,333:1-4.
[20]Gupta, D., U. C. Ghoshal, et al. Lactose intolerance in patients with irritable bowel syndrome from northern India:a case-control study. J Gastroenterol Hepatol,2007,22(12):2261-5.
[21]Farup, P. G., K. W. Monsbakken, et al. Lactose malabsorption in a population with irritable bowel syndrome:prevalence and symptoms. A case-control study. Scand J Gastroenterol,2004,39(7):645-9.
[22]Saberi-Firoozi, M., F. Khademolhosseini, et al. Subjective lactose intolerance in apparently healthy adults in southern Iran:Is it related to irritable bowel syndrome? Indian J Med Sci,2007,61(11):591-7.
[23]Vesa, T. H., L. M. Seppo, et al. Role of irritable bowel syndrome in subjective lactose intolerance. Am J Clin Nutr,1998,67(4):710-5.
[24]Tracy J.Parker,Jenny T.Woolner, et al. Irritable bowel syndrome:is the search for lactose intolerance justified? Eur J Gastroenterol Hepatol,2001,13:219-225.
[25]Gralnek, I. M., R. D. Hays, et al. Racial differences in the impact of irritable bowel syndrome on health-related quality of life. J Clin Gastroenterol,2004, 38(9):782-9.
[26]Chang L, Talley N, Thompson WG, Whitehead WE. Rome III:The Functional Gastrointestinal Disorders:The Rome Foundation,2006.
[27]Brennan MR, Spiegel T, Naliboff B, Mayer E, Bolus R, Chang L. Development and Initial Validation of a Concise Point-of-Care Severity Index in irritable bowel syndrome:The"B.E.S.T"Questionnaire. Gastroenterology,2008, DDW abstract.
[28]Masuda, M, T. H. Holmes. The Social Readjustment Rating Scale:a cross-cultural study of Japanese and Americans." J Psychosom Res,1967,11(2):227-37.
[29]Rahe, R. H. Epidemiological studies of life change and illness. Int J Psychiatry Med,1975,6(1-2):133-46.
[30]Miller, M. A, R. H. Rahe. Life changes scaling for the 1990s. J Psychosom Res, 1997,43(3):279-92.
[31]Bjelland, I., A. A. Dahl, et al. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res,2002,52(2): 69-77.
[32]Zigmond, A. S, R. P. Snaith. The hospital anxiety and depression scale. Acta Psychiatr Scand,1983,67(6):361-70.
[33]Herrmann, C. International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. J Psychosom Res,1997,42(1):17-41.
[34]杨月欣编著.中国食物成分表(第二册).北京大学医学出版社.2004.
[35]金海玲,周德平.肠易激综合征患者的心理评估.世界华人消化杂志,1999,7(7)：628.
[36]李云桥,候晓华.心理因素与肠易激综合征.胃肠病学和肝病学杂志,2002,11(4)：326-329.
[37]Lee, M. F., R. M. Russell, et al. Total intestinal lactase and sucrase activities are reduced in aged rats. J Nutr,1997),127(7):1382-7.
[38]Bohmer, C. J. and H. A. Tuynman The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome:a 5-year follow-up study. Eur J Gastroenterol Hepatol,2001,13(8): 941-4.
[39]Bohmer, C. J. and H. A. Tuynman The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol,1996, 8(10):1013-6.
[40]Bozzani, A., R. Penagini, et al. Lactose malabsorption and intolerance in Italians. Clinical implications. Dig Dis Sci,1986,31(12):1313-6.
[41]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[42]Weinryb, R. M., E. Osterberg, et al. Psychological factors in irritable bowel syndrome:a population-based study of patients, non-patients and controls. Scand J Gastroenterol,2003,38(5):503-10.
[43]Halder, S. L., J. McBeth, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol,2002,31 (6):1219-25; discussion 1225-6.
[44]Koloski, N. A., N. J. Talley, et al. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study. Am J Gastroenterol,2003,98(4):789-97.
[45]Cruz Ruiz, M. A., R. B. Ortiz Herrera, et al. Association of depression and anxiety in patients with irritable bowel syndrome. Rev Gastroenterol Mex,2007, 72(1):29-33.
[46]Thijssen, A. Y., D. M. Jonkers, et al. Dysfunctional cognitions, anxiety and depression in irritable bowel syndrome. J Clin Gastroenterol,2010,44(10): e236-41.
[47]Gulewitsch, M. D., P. Enck, et al. Irritable bowel syndrome symptoms among German students:prevalence, characteristics, and associations to somatic complaints, sleep, quality of life, and childhood abdominal pain. Eur J Gastroenterol Hepatol,2011,23(4):311-6.
[48]Grundmann, O. and S. L. Yoon Irritable bowel syndrome:epidemiology, diagnosis and treatment:an update for health-care practitioners. J Gastroenterol Hepatol,2010,25(4):691-9.
[49]熊守礼,陈旻湖,等.肠易激综合征患者生存质量的评价.中华内科杂志,2004,43(5)：356-9.
[1]Drossman, D. A. The Rome Foundation and Rome Ⅲ. Neurogastroenterol Motil,2007,19(10):783-6.
[2]Talley, N. J. and R. Spiller Irritable bowel syndrome:a little understood organic bowel disease? Lancet,2002,360(9332):555-64.
[3]Chang L, Talley N, Thompson WG, Whitehead WE. Rome Ⅲ:The Functional Gastrointestinal Disorders:The Rome Foundation,2006.
[4]Shaw, A. D. and G. J. Davies Lactose intolerance:problems in diagnosis and treatment. J Clin Gastroenterol,1999,28(3):208-16.
[5]Saito YA, Schoenfeld P, Locke GRI. The epidemiology of irritable bowel syndrome in North America:A systemic review. Am J Gastroenterol,2002,97: 1910-5.
[6]Gwee, K. A. Irritable bowel syndrome in developing countries--a disorder of civilization or colonization?" Neurogastroenterol Motil,2005,17:317-24.
[7]Longstreth, G. F. Definition and classification of irritable bowel syndrome: current consensus and controversies. Gastroenterol Clin North Am,2005,34: 173-87.
[8]Schmulson, M., O. Ortiz, et al. Frequency of functional bowel disorders among healthy volunteers in Mexico City. Dig Dis,2006,24:342-7.
[9]Chang FY, Lu CL. Irritable bowel syndrome in the 21st century:Perspectives from Asia or South-east Asia. J Gastroenterol Hepatol,2007,22:4-12.
[10]Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of Irritable bowel syndrome in Norway. Scand J Gastroenterol,2006,41:650-6.
[11]Celebi S, Acik Y, Deveci SE, et al. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol,2004,19:738-43.
[12]Makharia, G. K., A. K. Verma, et al. Prevalence of irritable bowel syndrome:a community based study from northern India. J Neurogastroenterol Motil,2011, 17(1):82-7.
[13]潘国宗,鲁素彩,等.北京地区肠易激综合征的流行病学研究：一个整群、分层、随机的调查.中华流行病学杂志,2000,21：26-9.
[14]熊守礼,陈旻湖,等.广东省社区人群肠易激综合征的流行病学研究.中华医学杂志,2004,84：278-81.
[15]Dai N, Cong Y, Yuan H. Prevalence of irritable bowel syndrome among undergraduates in Southeast China. Digestive and Liver Disease,2008,40: 418-24.
[16]Dong, Y. Y., X. L. Zuo, et al. Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome Ⅲ criteria." World J Gastroenterol,2010,16(33):4221-6.
[17]Poulter, M., E. Hollox, et al. The causal element for the lactase persistence/non-persistence polymorphism is located in a 1 Mb region of linkage disequilibrium in Europeans. Ann Hum Genet,2003,67(Pt 4):298-311.
[18]Sahi, T. Genetics and epidemiology of adult-type hypolactasia. Scand J Gastroenterol Suppl,1994,202:7-20.
[19]NandaR, James R, Smith H, Dudley CR, Jewell DP. Food intolerance and the irritable bowel syndrome. Gut,1989,30:1099-104.
[20]Bozzani, A., R. Penagini, et al. Lactose malabsorption and intolerance in Italians. Clinical implications. Dig Dis Sci,1986,31(12):1313-6.
[21]Bohmer, C. J. and H. A. Tuynman The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome:a 5-year follow-up study. Eur J Gastroenterol Hepatol,2001,13(8): 941-4.
[22]Bohmer, C. J. and H. A. Tuynman The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol,1996, 8(10):1013-6.
[23]Matthews, S. B., J. P. Waud, et al. Systemic lactose intolerance:a new perspective on an old problem. Postgrad Med J,2005,81(953):167-73.
[24]Tracy J.Parker,Jenny T.Woolner, et al. Irritable bowel syndrome:is the search for lactose intolerance justified? Eur J Gastroenterol Hepatol,2001,13:219-225.
[25]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[26]Weinryb, R. M., E. Osterberg, et al. Psychological factors in irritable bowel syndrome:a population-based study of patients, non-patients and controls. Scand J Gastroenterol,2003,38(5):503-10.
[27]Halder, S. L., J. McBeth, et al. Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study. Int J Epidemiol,2002,31(6):1219-25; discussion 1225-6.
[28]Koloski, N. A., N. J. Talley, et al. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study. Am J Gastroenterol,2003,98(4):789-97.
[29]Cruz Ruiz, M. A., R. B. Ortiz Herrera, et al. Association of depression and anxiety in patients with irritable bowel syndrome. Rev Gastroenterol Mex,2007, 72(1):29-33.
[30]Asahina, S., K. Hasegawa, et al. Depression in patients of irritable bowel syndrome. Nippon Rinsho,2006,64(8):1527-31.
[31]Thijssen, A. Y., D. M. Jonkers, et al. Dysfunctional cognitions, anxiety and depression in irritable bowel syndrome. J Clin Gastroenterol,2010,44(10): e236-41.
[32]Afsar, B., R. Elsurer, et al. Irritable bowel syndrome in haemodialysis: Prevalence, link with quality of life and depression. Nephrology (Carlton),2010, 15(2):197-202.
[33]Locke, G. R.,3rd, A. L. Weaver, et al. Psychosocial factors are linked to functional gastrointestinal disorders:a population based nested case-control study. Am J Gastroenterol,2004,99(2):350-7.
[34]Xiong, L. S., M. H. Chen, et al. A population-based epidemiologic study of irritable bowel syndrome in South China:stratified randomized study by cluster sampling. Aliment Pharmacol Ther,2004,19(11):1217-24.
[35]Tabas, G., M. Beaves, et al. Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet:a double-blind, placebo-controlled trial. Am J Gastroenterol,2004,99(5):914-20.
[36]Vahedi, H., S. Merat, et al. Clinical trial:the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 2008,27(8):678-84.
[37]Talley, N. J., J. E. Kellow, et al. Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome:a double-blind, randomized, placebo-controlled trial. Dig Dis Sci,2008,53(1):108-15.