Study On The Related Factors,syndromes And Constitution Of Irritable Bowel Syndrome(Diarrhea Type) Complicated With Depression

Objective: Through the cases of clinically relevant research,we scientifically evaluate the related factors of irritable bowel syndrome(diarrhea type)patients complicated with depression,and analyze the distribution of TCM syndrome differentiation and constitution types of them.What’s more,we explore the syndrome differentiation and physical constitution of patients with irritable bowel syndrome(diarrhea type),and the correlation between them and depression,which can provide a clinical reference for TCM prevention and treatment of irritable bowel syndrome(diarrhea type)patients complicated with depression.Methods: Questionnaires were conducted among the patients who met the diagnostic criteria of diarrheal irritable bowel syndrome and diarrheal irritable bowel syndrome combined with depression in the gastroenterology ward and outpatient department of Sichuan Hospital of Traditional Chinese Medicine.The general data,such as gender,age,course of disease,syndrome differentiation and physique information of the patients were collected.And the relevant data were input into Excel and carefully sorted out.Statistical methods such as chi-square test and regression analysis were used to analyze the related factors affecting the depression of patients with IBS-D by SPSS 22.0 statistical software.In order to explore the syndrome differentiation and physical constitution of patients with IBS-D,and the correlation between them and depression.Results: 1.A total of 136 cases meeting the inclusion criteria were collected,including77 patients with irritable bowel syndrome(diarrhea type)with depression,accounting for 56.6%,and 59 patients with irritable bowel syndrome(diarrhea type)without depression,accounting for 43.4%.2.According to the univariate analysis and multivariate regression analysis,the results showed that that gender,BMI,marital status,living style and monthly income had no statistical significance on the presence of depression in IBS-D(P > 0.05),while age,course of disease,symptom severity and education level had statistical significance on the presence of depression in IBS-D(P < 0.05).Among them,the duration and severity of symptoms were positively correlated with the presence of depression,while the age and educational level were negatively correlated with the presence of depression.3.The type of TCM syndrome differentiation of patients with irritable bowel syndrome(diarrhea type)complicated with depression from most to least were liver qi by spleen syndrome,spleen-stomach weakness syndrome,spleen and kidney Yang deficiency syndrome and large intestinal dampness-heat syndrome.However,the TCM syndrome differentiation of patients with IBS-D without depression from most to least were spleen-stomach weakness syndrome,large intestinal dampness-heat syndrome,liver qi by spleen syndrome and spleen and kidney Yang deficiency syndrome.The results showed there was no significant statistical difference in syndrome differentiation between IBS-D with depression and IBS-D without depression(P>0.05).4.The constitution types of patients with IBS-D complicated with depression in order from most to least were Qi-stagnation constitution,yang-insufficiency constitution,qi-insufficiency constitution,damp-heat constitution,phlegm-dampness constitution,yin-deficiency constitution,and blood stasis;However,the constitution types of patients with IBS-D without depression from most to least were yanginsufficiency constitution,qi-insufficiency constitution,damp-heat constitution,Qistagnation constitution,phlegm-dampness constitution,yin-deficiency constitution,normal constitution,blood stasis and special constitution.There were significant statistical differences between irritable bowel syndrome(diarrhea type)group with depression and the group without depression in the normal constitution and Qistagnation constitution(P<0.05),but there were no statistical differences in the other7 types of constitution(P>0.05).Conclusions: 1.The incidence of depression in patients with irritable bowel syndrome(diarrhea type)was not correlated with gender,BMI,marital status,residence style and monthly income,but it had relationship with age,course of disease,symptom severity and educational level.Among them,the longer the course of the disease,the more serious of the disease,the greater the probability of complicating with depression;while the older of the age,the higher the level of education,the lower the probability of complicating with depression.2.For the patients with IBS-D comorbid depression,the syndrome of liver qi taking advantage of spleen was the most,while for the patients which were without depression,the syndrome of spleen-stomach weakness was the most.There was no correlation between the comorbidity of depression in IBS-D patients and syndrome differentiation.3.The most constitution type of patients with IBS-D comorbid depression was Qi-stagnation constitution,while the most constitution type of IBS-D patients without depression was yang-insufficiency constitution.What’s more,the presence of depression or not was correlated with the Qi-stagnation constitution and normal constitution.