With the rapid advancement of Multi-modal Large Language Models (MLLMs), MLLM-based Image Quality Assessment (IQA) methods have shown promising performance in linguistic quality description. However, current methods still fall short in accurately scoring image quality. In this work, we aim to leverage MLLMs to regress accurate quality scores. A key challenge is that the quality score is inherently continuous, typically modeled as a Gaussian distribution, whereas MLLMs generate discrete token outputs. This mismatch necessitates score discretization. Previous approaches discretize the mean score into a one-hot label, resulting in information loss and failing to capture inter-image relationships. We propose a distribution-based approach that discretizes the score distribution into a soft label. This method preserves the characteristics of the score distribution, achieving high accuracy and maintaining inter-image relationships. Moreover, to address dataset variation, where different IQA datasets exhibit various distributions, we introduce a fidelity loss based on Thurstone’s model. This loss captures intra-dataset relationships, facilitating co-training across multiple IQA datasets. With these designs, we develop the Distribution-based multi-modal image Quality Assessment model (DimiQA). Experiments across multiple benchmarks show that DimiQA stably outperforms baselines in score regression. Also, DimiQA can predict the score distribution that closely aligns with human annotations. Codes and model weights will be released.