炎症性肠病患者服药依从性及其影响因素研宄柏亚妹宋玉磊卞秋桂王丹丹万红许晨陈菁倪冬梅南京中医药大学江苏省人民医院江苏省常州市中医院摘要：目的调査炎症性肠病(TBD)患者服药依从性现状及其影响因素。方法选取2014年11月一2015年11月在江苏省人民医院和常州市屮医院消化科就诊的IBD患者。采用改良的Morisky量表对IBD患者服药依从性进行评价;采用一般情况调查问卷、中文版克罗恩病与溃疡性结肠炎知识问卷(CCKNOW)、Zimg焦虑/抑郁自评量表(SAS/SDS)和社会支持评定量表进行调查，纳入可能对IBD患者服药依从性产生影响的因素，进行单因素分析和多元逐步线性冋归分析。结果共调查126例IBD患者，有效问卷118份，有效回收率为93.6%。其屮溃疡性结肠炎(UC)患者92例，克罗恩病(CD)患者26例。IBD患者服药依从性评分为(11.3±3.7)分,其中UC患者为(10.9±3.4)分,CD患者为(12.8±4.1)分两者比较，差异有统计学意义(t-2.365,P=0.020)。单因素分析结果显示，不同职业、文化程度、汕腻食物、饮食结构、疾病类型、药物不良反应者服药依从性评分比较，差异均有统计学意义(P〈0.05):年龄、CCKNOW评分、社会支持评分与服药依从性评分呈负相关(p<0.05);服药总数、SDS评分与服药依从性评分呈正相关(P<0.05)。多元线性回归分析结果显示，文化程度、年龄、服药总数、CCKNOW评分、社会支持评分是服药依从性评分的影响因素(P〈0.05)。结论TBD患者服药依从性较差，在今后的临床工作中要重视年龄、文化程度对IBD患者服药依从性的预警作用，同时要提高患者社会支持程度和知识宣教力度，简化用药方案，提高1BD患者服药依从性。关键词：炎症性肠病;服药依从性;影响因素分析;作者简介：倪冬梅，副主任护师;E-mail:jshlz@126.com收稿曰期:2017-04-05基金：W家自然科学基金面上资助项H(71573140)MedicationAdherenceandItsInfluencingFactorsamongInflammatoryBowelDiseasePatientsBAIYa-meiSONGYu_leiBIANQiu-guiWANGDan-danWANHongXUChenCHENJingNIDong-meiNanjingUniversityofChineseMedicine;JiangsuProvinceHospital;ChangzhouTCMHospital;Abstract：ObjectiveToinvestigatethestatusandinfluencingfactorsofmedicationadherenceamongpatientswithinflammatoryboweldisease(1BD).MethodsIBDpatientsreceivedtreatmentinDepartmentofGastroenterology,JiangsuProvinceHospitalandChangzhouTCMHospitalfromNovember2014toNovember2015wererecruited.MedicationadherencewasassessedbytheMoriskyMedicationAdherenceQuestionnaire(MAQ)，andthepossibleinfluencingfactorsformedicationadherencewereidentifiedbyaself-developedBaselineCharacteristicsQuestionnaire,Crohn’sandColitisKnowledge(CCKNOW,Chineseversion)score,ZungSelf-ratingAnxietyScale(SAS),ZungSelf-ratingDepressionScale(SDS)andSocialSupportRatingScale(SSRS).Univariateandstepwisemultiplelinearregressionanalyseswereperformedtoinvestigatetheinfluencingfactorsofmedicationadherence.ResultsAtotalof126patientswithIBDwereinvestigated,and118effectivequestionnaireswerecollectedwitharesponserateof93.6%.Therewere92patientswithulcerativecolitis(UC)，26patientswithCrohn’sdisease(CD)•TheaveragemedicationadherencescoreofIBDpatientswas(11.3±3.7)•CDpatientshadhigheraveragemedicationadherencescorethantheUCpatients[(12.8±4.1)vs.(10.9±3.4),t=-2.365,P=0.020].Univariateanalysisshowedthatmedicationadherencescoresignificantlyvariedbyoccupation,educationalattainment,frequencyoffattyfoodconsumption,diettype,diseasetype,prevalenceofadversedrugreactions(P<0.05).Pearsoncorrelationcoefficientanalysisshowedthatthemedicationadherencescorewasnegativelycorrelatedwithage,CCKNOWscoreandsocialsupportscore(P<0.05),whileitwaspositivelycorrelatedwiththetotalnumberofmedicationsandSDSscore(P<0.05).Stepwisemultiplelinearregressionanalysisfoundthateducationalattainment,age,to...