The Correlations About Clinical Symptoms With Intestinal Flora And The Change Of HPT In Irritable Bowel Syndrome

OBJECTIVE:Irritable bowel syndrome(IBS) is a clinical syndrome, characterized by abdominal pain, comfort and changes in stool frequency and character. IBS is one of the most common functional gastrointestinal disorder. The worldwide prevalence of10-20%,accounting for30%-50%of the digestive internal medicine clinic patients. After treatment, the recurrence rate is still high and symptoms is more complex, even affect patients’work and daily life and reduce the quality of life of the patients Significantly. And increase a great deal of psychological and economical burden for patients and their family. Patients often have mental change, and bring difficulties to the understanding and treatment of IBS. This research through cultivating intestinal bacteria, gastrointestinal symptom scores, HAMD depression scores and thyroid hormone and TSH measure. Investigate the correlation of intestinal flora, the HPT axis and its clinical symptoms in IBS patients.OBJECT AND METHODS:All selected patients were the First Affiliated Hospital of Zhengzhou University, gastroenterology clinic or hospital patients, who were diagnosed IBS exclusion of other diseases, a total of60cases. According to the Rome Ⅲ standards and Bristol stool scale is divided into diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C) two patient groups, Each group of30cases. The control group is30healthy subjects in our hospital. Two patients group do Stool bacterial culture, All subjects of the gastrointestinal symptom scores, HAMD depression scores and determination of thyroid hormone and TSH values.Through stool bacterial culture to understand the incidence of IBS patients with intestinal flora, whether the incidence of IBS-D and IBS-C patients with intestinal flora are difference. If there is alteration of intestinal flora, explore the correlations about gastrointestinal symptom scores, HAMD depression scores and thyroid hormone and TSH values. To do the research the relevance analysis about gastrointestinal symptom scores, HAMD depression scores and thyroid hormone and TSH values and strength of the study subjects.All data is analyzed in Statistical Product and Service Solutions17.0(spss17.0), using one-way analysis of variance for the multiple sets of quantitative data. First, we should analysis of the multiple sets of quantitative data normality test and homogeneity of variance. If they are obeying the normal distribution and homogeneity of variance, use one-way analysis of variance, Otherwise, use multiple sets of quantitative data non-parametric test(Kruskal-Wallis tests), then use Bonferroni Pairwise comparisons, analyzed whether the statistical differences exist between each group. Inspection level α=0.05, P<0.05, there was significant difference. Stool bacterial culture results is recorded according with the number of positive cases in two groups. Using the chi-square test(χ2) to understand whether the significant difference. And statistics whether the differences in the gastrointestinal symptoms scores, the HAMD scores, thyroid hormone and TSH values in imbalance of intestinal flora than other patients with IBS.RESULTS:1.Three groups of the gastrointestinal symptoms scores Kruskal-Wallis test and Bonferroni statistical analysis, P<0.05, there was significant difference in three groups, and the symptoms of IBS-D group is serious compared with IBS-C group.2.There are35cases HAMD depression scores8points or more than8points of all the three groups, the IBS-D group17cases, IBS-C group16cases, two cases in the control group, there was significant difference between two patients groups and the control group.3.There was no significant difference in FT3and FT4among the three groups. There are seven cases TSH values higher than t upper limit of normal reference value in IBS-D group, IBS-C group1cases is greater than the upper limit of normal reference value and1cases below the normal minimum reference value. All the TSH values were within the normal reference range in control group. There are no significant difference in TSH values among the three groups.4.There was found10cases of dominant bacterial growth in IBS-D group, including four cases’TSH value is abnormal. there were three cases of dominant bacterial growth in the IBS-C group, no abnormal TSH values. The statistical analysis about the incidence of imbalance of intestinal flora, P=0.029<0.05, there are statistically significant difference exists.5.There was correlation between TSH and gastrointestinal symptoms scores in IBS-D group. There was correlation between TSH and HAMD depression scores in the two patient groups. There are strong correlation between TSH values and gastrointestinal symptoms scores, HAMD depression scores in the8cases of abnormal TSH in patients.CONCLUSIONS:1. This is further evidence that IBS is a physical and mental disease, often accompanied by psychological changes, and there is existence of a certain degree of correlation between the degree of their severity clinical symptoms and psychological changes.2. It was a greater likelihood of IBS patients abnormal TSH values. Proved that had an impact on the HPT axis in IBS pathogenesis. At the same time, there is a certain correlation between the HPT axis changes with the degree of IBS symptoms. 3. The incidence imbalance of intestinal flora of patients with IBS-D group is higher than the IBS-C group, IBS-C Patients with imbalance of intestinal flora have with more severe symptoms.