精神心理因素相关性消化不良的诊断思维

以生物-心理-社会医学模式和整体医学观念重新思考与探讨功能性消化不良(FD)，指出FD命名缺乏特异性，罗马Ⅳ FD症状标准过于严格苛刻，病程要求过长，亚型分型的病理生理学依据欠充分，无精神心理障碍症状评估等。罗马标准适合用于科研，不完全适用于临床。根据精神心理因素与FD病因、症状、治疗、预后等密切关系，首次提出精神心理因素相关性消化不良(PAD)的新命名及其症状诊断标准、精神心理障碍症状评估和四项关注等完整的PAD诊断标准，供同道评鉴，使新医学模式和整体医学观念落实在临床实践具体操作中，更适用于临床。

Diagnostic thinking of psycho-associated dyspepsia

With the bio-psycho-social medical model and the concept of holistic medicine to revalve the functional dyspepsia (FD), we point out the defination of FD was lack of specificity, and the Rome Ⅳ criterion about FD is too strict with long disease course, insufficient pathophysiological theory for subtype classification and no assessment for mental disorder, etc.The Rome criteria was suitable for scientific research but not clinical practice.According to the close relationship between psycho-psychological factors and the symptoms, treatment and the prognosis of FD, we first put forward psycho-associated dyspepsia(PAD) and diagnostic criteria, symptom assessment of mental disorder, the four attention and other complete diagnostic criteria of PAD which could be implemented in clinical practice with new medical model and holistic medical concept, and more suitable for clinical practice.