慢性胃肠疾病的心身医学观

慢性胃炎是常见的消化系统疾病，其主要是由幽门螺旋杆菌感染引起的胃粘膜慢性炎症，虽然从18世纪已经有了慢性胃炎的诊断标准，但它仍旧存在许多临床上的困惑，缺乏客观的、容易执行的诊断标准。功能性胃肠病(FGIDs)是一组功能性胃肠疾病，功能性消化不良(FD)是FGIDs其中之一，与慢性胃炎从临床症状上不能鉴别。难治性慢性胃炎(CG)和FD因为医源性应激—过分夸大幽门螺旋杆菌感染引起癌变常常合并不同程度的情绪障碍(抑郁和焦虑)，实际上都是心身疾病。对于难治性慢性胃炎和功能性消化不良用常规治疗是无效的，可以从生物-心理-社会医学模式(心身医学)观点看待CG和FD就可以得出不同结论和新的治疗方法，可以用这一新观点解决CG和FD诊断和治疗上的困惑，从临床实践证明抗抑郁/焦虑疗法是有效的。

The psychosomatics viewpoint of chronic gastrointestinal disease

Chronic gastritis(CG) is one of the most common diseases of digestive system, which is mainly caused by the chronic gastric mucosa inflammation via H. pylori infection.Although it has presented the diagnosis standard of chronic gastritis in the 18th century, it still brings a lot of confusion to clinic for the lack of objectively and easily implemented diagnosis standard.Functional gastrointestinal diseases (FGIDs) is a group of functional gastrointestinal disorder, functional dyspepsia(FD) is one of FGIDs, it can′t be identified with CG from the clinical symptoms.Refractory CG and FD are often accompanied by varying degrees of mood disorder(depression and anxiety) because of iatrogenic stress, which exaggerated the risk of cancer induced by H. pylori infection.They are psychosomatic diseases actually, so routine treatment is ineffective for refractory CG and FD.We may get different conclusions and new therapeutic method from biopsychosocial model (psychosomatic medicine) to CG and FD.We can use new viewpoint to slove the confusion in the diagnosis and treatment of refractory FD and CG, and prove antidepressant and antianxiety therapy to be effective from the clinical practice.