ABSTRACT
Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.
ABSTRACT
@#Objective To investigate the effects of total glucosides of paeony (TGP) on mice with experimental ulcerative colitis and the underlying mechanisms. Methods Forty-eight mice were equally randomized into 6 groups ( n = 8): normal control group, model group, salicylazosulfapyridine (SASP) group, low-dose TGP group one day after enama, the mice were treated with corresponding agent by oral gavage for3 days. The disease activity index (DAI) score was evaluated every day. After all the mice were scarified, the macroscopic and histological scores were evaluated. The tumor necrosis factor-α (TNF-α) level of the colon mucosa was measured by ELISA and the colonic expression of nuclear factor-κB (NF-κB) p65 was detected by immunohistochemistry. Results Compared with the normal control group, the DAI score was significantly higher in the model group (P ＜0. 01 ),but was similar to that in low-dose TGP group ( P ＞ 0.05 ). Compared with the model group, the DAI score was significantly decreased in SASP group, medium-dose TGP group, and high-dose TGP group (all P ＜ 0. 05). The macroscopic score, histological score, TNF-α level, and expression of NF-κB p65 were significantly higher in model group than in normal control group, SASP group, medium-dose TGP group, and high-dose TGP group ( all P ＜0. 01 ), but was similar to that in low-dose TGP group (P ＞ 0. 05). The efficacy of TGP was higher in high-dose TGP group than in SASP group. Conclusions TGP has certain therapeutic effects on experimental ulcerative colitis,which may be achieved by its inhibitory effect on the activation of NF-κB and the production of TNF-α.