ABSTRACT
Functional dyspepsia( FD)is a common functional gastrointestinal disorder,its pathogenesis has not been fully clarified. Recent studies showed that gastrointestinal mucosal low-grade inflammation had been found in patients with FD,and impaired mucosal integrity,psychological factor and abnormal brain-gut axis may promote the inflammation formation,which may also contribute to the onset and persistence of FD. This article reviewed the advances in study on gastrointestinal mucosal low-grade inflammation in FD.
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.