多潘立酮片治疗功能性消化不良的临床研究

目的　评价多潘立酮治疗功能性消化不良 (FD)的疗效及安全性。方法　 72例FD患者随机分为两组 ,治疗组予以多潘立酮 (丽珠医药集团生产 ) 10mg ,3次 /d ,对照组予以多潘立酮 (西安杨森制药有限公司生产 ) 10mg ,3次 /d ,疗程均为 4周。治疗前存在胃排空延迟者 ,治疗后用小钡条法复查固体食物胃排空。结果　两组治疗 4周均可明显改善FD患者上腹胀、早饱、腹痛、烧心、食欲不振及嗳气等症状 ,与治疗前相比 ,差异有显著性 (P <0 .0 5 ) ;治疗组治疗前症状总积分为 13.92± 2 .0 3,治疗后为 3.89± 3.72 ,差异有显著性 (P <0 .0 1) ;治疗组上腹胀、早饱、腹痛、烧心、食欲不振及嗳气症状的有效率分别为 6 3.89% ,6 4 .71% ,5 7.14 % ,6 6 .6 7% ,6 4 .0 0 %及 5 8.6 2 % ;对照组治疗前症状总积分为 13.0 8± 3.92 ,治疗后为 4 .14± 2 .91,较治疗前也明显降低 (P <0 .0 1) ,对上腹胀、早饱、腹痛、烧心、食欲不振及嗳气症状的有效率分别为 5 0 .0 0 % ,6 5 .71% ,6 5 .2 2 % ,4 1.18% ,87.5 0 %及 4 4 .0 0 %。两组治疗前后的症状总积分及症状有效率比较 ,差异均无显著性 (P <0 .0 5 )。两组均可改善胃排空延迟患者胃排空率 ,有效率均为 73.33% ,差异无显著性 (P >0 .0 5 )。两组患者治疗后均未发现不良反应     

胃排空障碍与功能性消化不良相关性的研究

目的：探讨胃排空障碍与功能性消化不良（FD）之间的关系。方法：以双核素标记试餐SPECT技术检测了22例FD患者的液、固体食物胃排空和食物胃内分布，并以实时超声检测了72例FD患者在西沙必利治疗前后的液体胃排空变化，分析这些变化与症状积分变化的相关性．结果：68．2％的FD患者存在胃排空障碍，以固体胃排空延迟为主，单纯液体排空障碍较少；摄食后比对照组有更多的食物滞留于远端胃内，然而，延迟的胃排空和改变了的固体食物胃内分布与FD的主要症状无显著相关性。西沙必利明显缩短FD患者的液体胃排空时间，改善其中部分患者的临床症状，而另一部分患者的症状无明显缓解．结论：西沙必利改善FD症状并非完全依赖于其促排空效应，胃排空障碍与FD之间缺乏必然的联系，它们可能是同一病生基础的两种不同表现．     

多潘立酮联合阿米替林治疗功能性消化不良的meta分析

目的对多潘立酮联合阿米替林治疗功能性消化不良的疗效及安全性进行评价。方法计算机检索1991年01月01日至2014年06月01日中国学术期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库(WANFANGDATA)、中国生物医学文献数据库(CBMdisc)、Pubmed数据库、Google Book Search等有关多潘立酮联合阿米替林治疗功能性消化不良的随机对照试验(RCT)文献,补充手工检索文献。应用Rev Man5.2软件对入选试验进行Meta分析。结果共8项随机对照试验符合入选标准,共743例功能性消化不良患者,其中接受多潘立酮联合阿米替林治疗共372例患者(试验组),371例患者单用多潘立酮治疗(对照组)。Meta分析结果显示试验组总体有效率(92.5%)明显高于对照组(74.9%,RR:1.23,95%CI:1.16~1.32,P0.000 01),上腹痛腹胀、恶心呕吐、烧心反酸等症状显效率(64.8%)也明显高于对照组(42.0%,RR:1.54,95%CI:1.34~1.77,P0.000 01)。两组不良反应发生率无统计学差异(RR:1.40,95%CI:0.71~2.78,P=0.33)。结论多潘立酮联合阿米替林治疗功能性消化不良疗效优于单用多潘立酮,安全性好,可以成为临床治疗功能性消化不良的一种较佳治疗方案。     

Dietary influence on electrogastrography and association of alterations in gastric myoelectrical activity with symptoms in patients with functional dyspepsia

Background and Aim: It is unclear which type of meal is adequate in measuring electrogastrography and which parameter of electrogastrography is of clinical relevance. The aims of the present study were to compare the influence of water and a nutrient drink on electrogastrography in patients with functional dyspepsia (FD) and in healthy volunteers, and to investigate the association of alterations of electrogastrography with symptoms. Method: In 30 patients with FD and 12 healthy volunteers, the recording of electrogastrography with symptom assessments was performed preprandially and postprandially. Subjects ingested the same volume of water and a nutrient drink at a fixed rate, which was performed in a randomized cross‐over design. Results: Unlike water, the power ratio after/before a nutrient drink was significantly lower in patients compared to controls. Patients had more severe bloating and epigastric pain after nutrient ingestion than after water intake. Absent postprandial increase of power was observed in seven of the 30 patients after nutrient intake, and in three of the 30 patients after water intake. The former patients had significantly more severe fullness and bloating. Irrespective of a test meal, the percentage rates of normogastria significantly decreased postprandially in the patient group, but not in the control group. No differences in symptom severity were observed between patients with and without abnormally low percentage rates of normogastria. Conclusions: Decreased postprandial rates of normogastria and absent postprandial increase of power are electrogastrographic abnormalities found in a subset of patients with FD. A nutrient drink is more adequate for the detection of such alterations than water. The lack of a postprandial increase of power is associated with the severity of some dyspeptic symptoms, but decreased postprandial rates of normogastria are not.     

功能性消化不良患者胃排空与症状的相关性及影响因素分析

目的了解胃排空异常与消化不良症状的相关性,分析影响功能性消化不良（FD）患者胃排空的因素。方法纳入32例FD患者。量化记录餐后上腹饱胀、上腹痛、上腹烧灼感、早饱、嗳气、恶心、呕吐7组症状及静息心率。以心率的中位数将其转化为二分类变量进行非条件Logistic回归分析统计。运用核素闪烁法检测空腹固体试餐,试餐参考美国胃肠动力学会、神经胃肠学会及核医学联合推荐的标准低脂试餐以及诊断标准。结果 32例FD患者,8例（25%）T1/2延迟,7例（21.88%）Retention%2 h增加,Retention%1 h均在正常范围内。Retention%2 h正常组与Retention%2 h增加组以及T1/2正常组与T1/2延长组之间,心率均存在显著差异（P=0.031,P=0.022）,心率与Retention%2 h、T1/2存在正相关（r=0.448,P=0.01;r=0.423,P=0.016）。在控制了性别、年龄及其他症状因素的影响下,心率〉70 bpm是Retention%2 h增加、T1/2延长的独立因素（OR=12.378,P=0.042;OR=8.180,P=0.072）。在Retention%2 h正常组与Retention%2 h增加组之间恶心症状指数有显著差异（P=0.003）,恶心与Retention%2 h、T1/2存在正相关（r=0.527,P=0.002;r=0.381,P=0.032）。结论心率、恶心症状与功能性消化不良患者的胃排空存在一定相关性,在控制了性别、年龄、BMI及其他症状的因素影响下,静息心率增加、出现恶心症状可能是胃排空延缓的独立因素。     

吗丁啉缓解消化不良症状的疗效观察——全国多中心、开放、前瞻性研究

目的评价吗丁啉（多潘立酮）2周治疗缓解消化不良症状的疗效，统计各种消化不良症状在门诊患者中的发生率；了解治疗过程中各种不良事件的发生率。方法选取2006年7月～2006年12月全国31个中心具有消化不良症状的门诊患者2067例，给予吗丁啉10mg，tid，餐前15～30min服用，连续用药2周。治疗1周、2周后对消化不良症状进行评分，记录治疗期间的合并用药、不良事件。结果患者基线时临床症状总积分为（14．49±6．70）分，中位数为14分。治疗1周和2周后总积分分别为（5．87±5．00）分和（1．97±3．08）分，中位数分别为5分和2分（P〈0．0001）。治疗1周和2周后的显效率分别为26．12％和71．65％，治疗2周效果优于1周，治疗2周末的总有效率为92．55％。患者主要症状的消失时间平均为4～8d（中位数），其中恶心和呕吐为4d，依次为食欲不振、上腹痛、早饱、嗳气、上腹胀。上腹胀的发生率最高，为90．37％，并且以中、重度者居多。其次是暖气（70．49％），以轻、巾度居多；依次为早饱（65．3％）、上腹痛（57．80％），食欲不振（48．99％）、恶心（33．37％）和呕吐（8．62％），均为轻度者居多。本研究共有26例受试者出现不良事件，占总例数的1．26％，其中23例为相关不良事件。在发生的23例相关不良事件中有5例为头晕，4例为溢乳。结论吗丁啉能够显著改善消化不良各项症状。2周治疗疗效显著优于1周治疗，提示消化不良促动力治疗应维持不少于2周。吗丁啉治疗消化不良安全性良好，不良事件发生率低。     

Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia

BACKGROUND/AIMS: We aimed to evaluate the role of fat and cholecystokinin (CCK) in the pathophysiology of functional dyspepsia (FD) by investigating symptoms and plasma CCK levels following increasing doses of duodenal lipid during gastric distension, and the effect of CCK-A receptor blockade. SUBJECTS/METHODS: In study A, six FD patients were studied on three occasions during duodenal infusion of saline or lipid (1.1 (L-1) or 2 kcal/min (L-2)) and proximal gastric distensions. Six healthy subjects were also studied as controls during L-2 only. In study B, the effect of the CCK-A antagonist dexloxiglumide (5 mg/kg/h) on L-2 induced symptoms was studied in 12 FD patients. Changes in gastric volume at minimal distending pressure and plasma CCK (study A) were assessed, gastric distensions were performed using a barostat, and dyspeptic symptoms were monitored. RESULTS: Lipid increased gastric volume compared with saline (DeltaV (ml): saline 15 (20), L-1 122 (42), L-2 114 (28)) in patients and even more so in controls (221 (37); p<0.05). During distensions, symptoms were greater during L-2 than during saline or L-1, and greater in patients than in controls, while gastric compliance was smaller in patients than in controls (p<0.05). Lipid increased plasma CCK levels in patients and controls (p>0.05). Dexloxiglumide abolished the increase in gastric volume (DeltaV (ml): dexloxiglumide 17 (9), placebo 186 (49)) and dyspeptic symptoms (sum of scores: dexloxiglumide 24 (7), placebo 44 (19)) during duodenal lipid infusion. Dexloxiglumide also reduced gastric compliance (ml/mm Hg: dexloxiglumide 51 (7), placebo 72 (11)) and symptoms (sum of scores: dexloxiglumide 101 (17), placebo 154 (21)) during gastric distension. CONCLUSION: CCK-A receptors are involved in the generation of dyspeptic symptoms by duodenal lipid during gastric distension.     

吗丁啉联合达吉对老年功能性消化不良患者胃动力及血清PG、G-17水平的影响

目的探讨吗丁啉(多潘立酮)联合达吉(复方消化酶)对老年功能性消化不良(FD)患者的胃动力以及血清胃蛋白酶原(PG)、胃泌素-17(G-17)水平的影响。方法选取2014年3月至2016年3月接受治疗的84例老年FD患者,随机分为对照组和试验组,每组各42例,对照组患者仅给予口服吗丁啉治疗,试验组在对照组治疗基础上联合达吉治疗,对比分析两组的临床疗效和临床症状改善情况,比较两组治疗前后血浆瘦素(LEP)、胃动素(MTL)、促肾上腺皮质激素释放激素(CRH)、PGⅠ、PGⅡ及G-17水平。结果对照组的临床治疗总有效率为66.67%,试验组为90.48%(P0.05);治疗后对照组各临床症状改善率显著低于试验组(P0.05);治疗后两组的餐前LEP、餐后LEP和MTL水平较治疗前均显著升高,CRH水平则明显降低(P0.05),试验组治疗后餐前LEP、餐后LEP和MTL含量均显著高于对照组,CRH水平显著低于对照组(P0.05);治疗后两组的血清PGⅠ、PGⅡ和G-17水平较治疗前均明显升高,胃蛋白酶原比值(PGR)则明显降低(P0.05),试验组治疗后血清PGⅠ、PGⅡ和G-17水平均显著高于对照组,PGR显著低于对照组(P0.05)。结论吗丁啉联合达吉治疗老年FD患者的临床效果显著,对胃动力的恢复有显著促进作用,还可显著提升患者血清PG和G-17的水平。     

Drug treatment of functional dyspepsia

Symptomatic improvement of patients with functional dyspepsia after drug therapy is often incomplete and obtained in not more than 60% of patients. This is likely because functional dyspepsia is a heterogeneous disease. Although great advance has been achieved with the consensus definitions of the Rome I and II criteria, there are still some aspects about the definition of functional dyspepsia that require clarification. The Rome criteria explicitly recognise that epigastric pain or discomfort must be the predominant complaint in patients labelled as suffering from functional dyspepsia. However, this strict definition can create problems in the daily primary care clinical practice, where the patient with functional dyspepsia presents with multiple symptoms. Before starting drug therapy it is recommended to provide the patient with an explanation of the disease process and reassurance. A thorough physical examination and judicious use of laboratory data and endoscopy are also indicated. In general, the approach to treat patients with functional dyspepsia based on their main symptom is practical and effective. Generally, patients should be treated with acid suppressive therapy using proton-pump inhibitors if the predominant symptoms are epigastric pain or gastroesophageal reflux symptoms. Although the role of Helicobacter pylori (H pylori) in functional dyspepsia continues to be a matter of debate, recent data indicate that there is modest but clear benefit of eradication of H pylori in patients with functional dyspepsia. In addition, H pylori is a gastric carcinogen and if found it should be eliminated. Although there are no specific diets for patients with FD, it may be helpful to guide the patients on healthy exercise and eating habits.     

Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients

AIM: Delayed gastric emptying and an enlarged fasting gastric antrum are common findings in functional dyspepsia but their relationship with gastrointestinal (GI), and the frequently associated extra-GI symptoms remains unclear. This study evaluated the relationship between GI and extra-GI symptoms, fasting antral volume and delayed gastric emptying in functional dyspepsia. METHODS: In 108 functional dyspeptic patients antral volume and gastric emptying were assessed with ultraso-nography (US). Symptoms were assessed with standardized questionnaire. The association of symptoms and fasting antral volume with delayed gastric emptying was estimated with logistic regression analysis. RESULTS: Delayed gastric emptying was detected in 39.8% of the patients. Postprandial drowsiness (AOR 11.25; 95%CI 2.75-45.93), nausea (AOR 3.51; 95%CI 1.19-10.32), fasting antral volume (AOR 1.93; 95%CI 1.22-3.05), were significantly associated with delayed gastric emptying. Symptoms, mainly the extra-GI ones as postprandial drowsiness and nausea, combined with fasting antral volume predicted the modality of gastric emptying with a sensitivity and specificity of 78%. CONCLUSION: In functional dyspeptic patients, (1) an analysis of fasting antral volume and of symptoms can offer valuable indication on the modality of gastric emptying, and (2) it seems appropriate to inquire on postprandial drowsiness that showed the best correlation with delayed gastric emptying.     

Plasma levels of acylated ghrelin in patients with functional dyspepsia

AIM: To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia.METHODS: Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study. The functional dyspepsia patients were each diagnosed based on the Rome III criteria. Eligible patients completed a questionnaire concerning the severity of 10 symptoms. Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit; electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal.RESULTS: There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia. However, in patients with functional dyspepsia, there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain (r = -0.427, P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety (r = 0.428, P =0.047). Additionally, there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria (%) (r = -0.522, P = 0.013). Interestingly, two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal.CONCLUSION: Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia.     

针刺对功能性消化不良患者近端胃动力的影响

目的：观察针刺对功能性消化不良患者机械性胃扩张近端胃动力的影响．方法：功能性消化不良患者60例分为针灸组和对照组,分别进行等容机械性胃扩张．观察近端胃动力参数：最小牵张压(MDP),初始容积和压力,最大耐受容积、压力和顺应性(容积和压力的比值)．结果：两组最小牵张压无显著性差异(5．28±2．62mmHg vs 4．98±1．87mmHg,P＞0．05),针灸组的初始压力和容积(8．06±2．95mmHg vs 5．40±2．41mmHg,560．9±119．5mL vs 352．0±139．3mL),最大耐受压力和容积(13．25±2．23mmHg vs 9．82±1．9mmHg,810．7±119．62mL vs 504．1±159．6mL),顺应性(61．2±18．6mL/mmHg vs 51．4±17．8mL/mmHg)均显著高于对照组(P＜0．05)．结论：针灸可以显著提高功能性消化不良患者的近端胃动力,降低内脏敏感性．     

多潘立酮对功能性消化不良患者阻抗式胃动力的影响

目的观察多潘立酮对功能性消化不良(FD)餐后不适综合征(PDS组)和上腹疼痛综合征(EPS组)临床症状和胃动力的影响。方法对2008年10月至2009年4月重庆医科大学附属第一医院消化内科门诊57例FD患者行症状分型和评分、检测餐后胃电和胃阻抗,多潘立酮10mg每日3次治疗2周和4周后,再次评分并复查胃动力。结果治疗2周后,PDS组和EPS组餐后饱胀不适、早饱感、上腹痛、上腹烧灼感症状较治疗前显著改善(P0.05);4周后除PDS组上腹烧灼感和EPS组早饱感、上腹痛外余症状均进一步改善(P0.05)。治疗前和治疗后2周及4周PDS组和EPS组的胃电中频百分比差异均有统计学意义(P0.05)。PDS组治疗2周后胃阻抗中频百分比较治疗前显著提高,4周后进一步提高(P0.05);治疗4周后,EPS组胃阻抗中频百分比显著高于治疗前和治疗后2周(P0.05)。结论多潘立酮治疗4周后FD患者的临床症状、胃电和胃阻抗显著改善,明显优于治疗后2周。     

功能性消化不良症状和近端胃功能的关系

目的:探讨功能性消化不良(functional dyspepsia,FD)症状与近端胃敏感性、容受性及顺应性的关系.方法:记录32例健康志愿者和59例FD患者的基本人口学特征和消化不良症状,患者空腹行电子恒压器检查,将前端带有气囊的双腔聚乙烯导管经口插入受试者胃内,给予等压扩张,检测指标包括近端胃敏感性、容受性及顺应性;同样,所有受试者第二天空腹行胃排空功能检查,利用核素闪烁法测定胃的固体排空功能,得出全胃排空标准曲线并计算全胃半排时间.利用2和Logistic回归分析消化不良症状与近端胃功能关系.结果:44.07%的FD患者存在内脏敏感性增加,内脏敏感性正常组和增加组之间胃半排时间无差异.内脏敏感性增加的患者上腹痛症状发生率高于内脏敏感性正常的患者(P<0.01);上腹痛症状是内脏敏感性增加的相关因素(OR=4.430,P<0.05).37.29%的FD患者存在近端胃容受性减低,容受性正常组和减低组胃半排时间无差异.近端胃容受性减低的患者早饱症状的发生率高于近端胃容受性正常的患者(P<0.05);早饱症状是近端胃容受性减低的独立相关因素(OR=3.231,P<0.05).54.24%的FD患者存在顺应性减低,顺应性正常组和减低组之间胃半排时间及消化不良症状发生率均无显著差异(P>0.05).结论:FD患者的症状与近端胃功能障碍有关,上腹痛症状提示内脏敏感性增加,早饱症状提示近端胃容受性减低.     

Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux

AIM:To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux(DGR).METHODS:The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group.The diagnosis was based on the combination of several objective arguments:a long history of gastric symptoms(i.e.,nausea,epigastric pain,and/or bilious vomiting) poorly responsive to medical treatment,gastroesophageal reflux symptoms unresponsive to protonpump inhibitors,gastritis on upper gastrointestinal(GI) endoscopy and/or at histology,presence of a bilious gastric lake at > 1 upper GI endoscopy,pathologic 24-h intragastric bile monitoring with the Bilitec device.Gas-tric juice was aspirated in the GI endoscopy and total bile acid(TBA),total bilirubin(TBIL) and direct bilirubin(DBIL) were tested in the clinical laboratory.Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman’s rank correlation test and Fisher’s linear discriminant analysis.Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists.Using the Independent-samples Mann-Whitney U-test,DGR index(DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy.Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR.RESULTS:The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group.There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux.The bile acid levels of DGR patients were significantly higher than the control values(Z:TBA:-8.916,DBIL:-3.914,TBIL:-6.197,all P < 0.001).Two of three in the DGR group have a significantly associated with e     

常规疗法联用盐酸帕罗西汀治疗功能性消化不良的疗效观察

目的评价常规疗法联合应用盐酸帕罗西汀治疗功能性消化不良(FD)的疗效。方法将93例FD患者随机分为两组,对照组患者用常规方法治疗,治疗组患者在常规治疗方法基础上加用盐酸帕罗西汀治疗,20 mg/次,1次/d,疗程6周,比较两组患者的临床治疗效果。结果治疗组患者治疗总有效率(95.7%)显著高于对照组患者(76.1%),治疗组患者临床疗效显著优于对照组患者,差异有统计学意义(P0.01)。治疗组患者复发率(12.8%)显著低于对照组患者(30.4%),差异有统计学意义(P0.05)。结论在常规治疗方法基础上联用盐酸帕罗西汀治疗功能性消化不良疗效显著、安全性高,值得临床推广应用。     

胃液pH值在慢性胃炎和功能性消化不良中的变化

目的了解在慢性胃炎和功能性消化不良(FD)这两种疾病的患者胃液中胃酸的pH值变化及胃液分泌功能的改变,进而正确指导抑酸剂的临床合理应用。方法采用胃镜下黏膜观察及活检病理,108例符合条件患者分为三组:慢性非萎缩性胃炎组(53例)、慢性萎缩性胃炎组(15例)、功能性消化不良组(40例)。30例健康体检者作为正常对照组。所有纳入患者行胃液pH值检测。结果与正常对照组相比,慢性萎缩性胃炎组、慢性非萎缩性胃炎组和功能性消化不良组患者胃液pH均升高,但差异无统计学意义(P>0.05)。三组之间的胃液pH值水平无统计学差异(P>0.05)。结论在针对慢性胃炎和FD患者临床治疗中,持续大量应用质子泵抑制剂是不适宜的。     

功能性消化不良患者胃十二指肠运动功能的研究

目的 探讨功能性消化不良患者的胃十二指肠运动功能改变,方法 对31例FD患者进行胃十二指肠测压研究,并与29例正常人对照,结果 FD患者消化间期移动性复合运动（MMC）Ⅲ期缺乏,占71%,同时Ⅲ期收缩波幅及胃窦Ⅲ期持续时间缩短。结论 FD患者存在胃十二指肠运动异常,可能是其致病原因之一。     

Development and evaluation of a modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease to distinguish functional dyspepsia from non-erosive reflux disease

Background and Aim: The Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG) is the standard questionnaire used in Japan for the diagnosis of gastroesophageal reflux disease (GERD) and assessment of the response to treatment. We modified the FSSG in order to assess dyspepsia symptoms, and evaluated the modified questionnaire. Methods: We modified the FSSG by adding two questions on interdigestive and postprandial epigastric pain. We then assessed the modified FSSG with 100 new untreated symptomatic patients presenting to hospital and in 200 subjects undergoing health checks. Endoscopic assessment of the esophagogastric junction was performed according to the modified Los Angeles classification with addition of Grade N (normal appearance) and Grade M (minimal change). Endoscopic images were assessed by five experienced endoscopists blinded to the questionnaire results. Results: The 100 new patients included 16 with erosive GERD (>Grade A), 12 with peptic ulcer, and two with gastric cancer. Among the 70 patients with no evidence of organic disease, the modified FSSG diagnosed functional dyspepsia (FD) in 41 and non‐erosive gastric disease (NERD) in 29. A significant difference was seen in the dyspepsia score between patients with FD and NERD. Subjects with endoscopic GERD undergoing health checks had significantly higher scores for all symptoms, reflux symptoms, and dyspeptic symptoms on the modified FSSG. Conclusion: The modified FSSG can clearly distinguish FD from NERD, and is useful for the assessment of dyspeptic symptoms.