| Objective 1.To detect the serum levels of corticotropin-releasing factor(CRF),calcitonin gene-related peptide(CGRP)in subgroups of FD patients,and the patients with or without anxiety/depression,to evaluate the gastrointestinal symptoms and anxiety/depression as well,and to study the relationship between CRF,CGRP and FD classification,to analyze the relationship between the two serum indexes and gender,and their correlation with dyspepsia symptoms,anxiety/depression.2.To compare the serum levels of CRF,CGRP and scores of functional dyspepsia symptom quantification,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)of patients before and after treatment with flupenthixol mesilate tablets(Delixin),to explore the changing of CRF,CGRP levels in subgroups of FD patients before and after treatment,and to assess the clinical efficacy of anti-anxiety and depression in the treatment of FD.Methods(This study is consist of two parts: experiment 1 and experiment 2)experiment 1: 1.From May 2015 to December 2016,the experimental samples were selected from the outpatients of Digestive department who met the Rome III criteria of FD in Lu’an People’s Hospital.The experimental data were collected and divideded into three groups: postprandial distress syndrome(PDS),epigastric pain syndrome(EPS)and PDS overlapping EPS.A total of 66 cases were selected randomly,each group contains 22 cases.Also,30 cases of healthy people blood samples were set up as the control group.The severity of FD symptoms was evaluated by the quantification of functional dyspepsia symptom,the anxiety and depression status of the subjects were assessed by Hamilton Anxiety and Depression Scale(HAMA/HAMD).The patients with PDS group,EPS group and PDS overlapping EPS group were divided into anxiety/depression group and no anxiety/depression group,according to HAMA / HAMD scores.2.The serum levels of CRF/CGRP in the patients were measured by enzyme-linked immunosorbent assay(ELISA),The data were compared between FD subgroups and the normal control,and among the subgroups,as well as those patients with or without anxiety/depression in each subgroups,to explore the correlation between the serum CRF/CGRP level and different subtypes FD and gender.3.Compared with the FD subgroups and the normal control group,the symptom quantification score and HAMA/HAMD score between subgroups,the relationships among dyspeptic symptoms,anxiety/depression status and FD classifications was analyzed.To investigate the relationship between dyspepsia symptoms,anxiety/depression and FD classification in patients with FD,and to explore whether there is correlation between the scores and the levels of CRF/ CGRP.experiment 2: 1.The origin of experiment 2 was the same as that of the experiment 1,After the data collection,the patients were treated with flupentixol melitracen tablets(Dai Li Xin)for oral treatment(one tablet each after the breakfast and lunch),after 4 weeks of follow-up,the patients were evaluated for dyspepsia,HAMA/HMMD score again,Twenty patients were randomly selected from the PDS,EPS,and PDS overlapping EPS group as the experimental groups respectively,and 20 patients in the control group were selected as the control group.The experimental group was divided into anxiety/depression group and no anxiety/depression group according to HAMA/HMMD score before treatment.2.Symptom quantification score and HAMA/HMMD scores were compared between pre-treatment and post-treatment for analyze the changes of digestive symptoms and anxiety/depression after use Deanxit in the treatment of FD.3.ELISA test was used to detect the serum CRF/CGRP levels in each subgroup before and after treatment,then comparing the difference.4.To analyze the changes of serum CRF/CGRP concentration,symptom quantification score,HAMA/HAMD score before and after treatment in anxiety/depression group and non-anxiety/depression group,and evaluate the efficacy of anti-anxiety/depression treatment single use Deanxit in treating FD.Results experiment 1: 1.The HAMA scores of PDS group,EPS group,PDS overlapping EPS group and control group were 19.45±9.11,14.73±6.04,16.36±8.96 and 3.70±2.85 respectively,and HAMD scores were 18.01±7.95,17.16±6.06,20.88±7.84,5.16±3.20,(P<0.05).The score of HAMA and HAMD in PDS group,EPS group and PDS overlapping EPS group were significantly higher than those in control group(P<0.05).HAMA score of PDS group was higher than PDS overlapping EPS group and EPS group(P<0.05),there was no significant difference in HAMD score among those groups of FD(P>0.05).2.The dyspepsia symptom quantification score in PDS group,EPS group,PDS overlapping EPS group and control group were 7.00±2.88,6.64±2.89,9.00±2.59 and 1.89±0.32 respectively.the scores in PDS group,EPS group,PDS overlap EPS group were higher than those in control group(P<0.05),and the scores in PDS overlapping EPS group were higher than those in PDS group and EPS group(P<0.05).3.The concentration of serum CRF in PDS group,EPS group,PDS overlapping EPS group and control group were 6.90±3.15ng/ml,6.30±4.42ng/ml,6.41±3.94ng/ml,3.00±1.99ng/ml.the levels of CRF in the three subgroups were higher than control group(P<0.05),but there was no significant difference among the three subgroups(P>0.05).4.The serum CRF levels of PDS group,EPS group,PDS overlapping EPS group patients with anxiety/depression were 8.20±2.94ng/ml,8.05±4.36ng/ml and 7.70±3.76ng/ml,patients without anxiety/depression in each group were 4.08±1.00 n /ml,3.23±2.53ng/ml,3.17±2.16ng/ml,The serum CRF concentrations of anxiety/depression patients were significantly higher than those without anxiety/depression in the three groups(P<0.05).5.The concentration of serum CGRP in PDS group,EPS group,PDS overlapping EPS group and control group were 129.70±22.69pg/ml,139.75±21.97pg/ml,133.79±20.77pg/ml,99.59±24.77pg/ml.the levels of CGRP in the three subgroups were higher than control group(P<0.05),but there was no significant difference among the three subgroups(P>0.05).6.The serum CGRP levels of PDS group,EPS group,PDS overlapping EPS group patients with anxiety/depression were 137.18±15.66pg/ml,145.96±18.21pg/ml,143.42±15.36pg/ml,patients without anxiety/depression in each group were113.68±28.11pg/ml,128.88±24.91pg/ml,113.17±15.22pg/ml,The serum CGRP concentrations of anxiety/depression patients were significantly higher than those without anxiety/depression in PDS group and PDS overlapping EPS group(P<0.05).7.The correlation coefficients of CRF and symptom quantification score/HAMA/HAMD scores were 0.313,0.251,0.254 respectively,were positively correlated among CRF and the three scores(P<0.05);The correlation coefficients of CGRP and symptom quantification score/HAMA/HAMD scores were 0.133,0.388,0.413 respectively,which were positively correlated with CGRP and HAMA/HAMD scores(P<0.001).experiment 2: 1.Before treatment the HAMA scores of PDS group,EPS group and PDS overlapping EPS group were 20.85±8.50,15.20±6.22,20.55±8.56,and HAMD scores were 18.95±7.13,17.15±5.79 and 19.15±8.21 respectively,after treatment the HAMA scores were 7.15±2.87,6.90±3.95,6.95±4.49,the HAMD scores were 5.85±3.20,6.75±3.86 and 5.65±3.59,after treatment the scores of HAMA and HAMD in the subgroups were lower than those before treatment(P <0.001).2.Before treatment the symptom quantification score of PDS group,EPS group and PDS overlapping EPS group were 7.05±2.19,6.15±2.40,9.10±2.61,after treatment the scores were 1.30±1.46,2.40±1.90,1.60±1.31,after treatment the scores of symptom quantification in the subgroups were lower than those before treatment(P <0.001).3.Before treatment the serum CRF concentrations of PDS group,EPS group and PDS overlapping EPS group were 6.93±3.21ng/ml,6.81±3.40ng/ml,6.37±3.04ng/ml,after treatment the concentrations were 4.12±1.60ng/ml,3.90±2.48ng/ml,3.74±2.17ng/ml,after treatment the serum CRF concentrations in the subgroups were lower than those before treatment(P <0.05).4.Before treatment the serum CGRP concentrations of PDS group,EPS group and PDS overlapping EPS group were 123.86±27.53pg/ml,127.03±25.61pg/ml,120.43±29.31pg/ml,after treatment the concentrations were 95.25±20.42pg/ml,105.10±23.17pg/ml,101.13±24.51pg/ml,after treatment the serum CGRP concentrations in the subgroups were lower than those before treatment(P <0.05).5.Before treatment the serum CRF/CGRP concentrations of patients with anxiety/depression were 7.05±3.51ng/ml,121.95±27.62pg/ml,the symptom quantification/HAMA/HAMD scores were 7.80±2.69,21.78±6.87,20.80±6.21,after treatment the serum CRF/CGRP concentrations were 4.11±2.15ng/ml,105.88±21.72pg/ml,the symptom quantification/HAMA/HAMD scores were 1.72±1.44,7.74±3.58,6.54±3.48,in patients with anxiety/depression,the serum CRF/CGRP concentration,symptom/HAMA / HAMD scores were all significantly lower after treatment than before treatment(p<0.01).6.Before treatment the serum CRF/CGRP concentrations of patients without anxiety/depression were 5.56±2.80ng/ml,129.79±25.74pg/ml,the symptom quantification/HAMA/HAMD scores were6.21±2.29,9.29±3.00,10.57±2.38,after treatment the serum CRF/CGRP concentrations were3.29±1.82ng/ml,82.80±16.58pg/ml,the symptom quantification/HAMA/HAMD scores were 1.93±2.16,4.57±3.41,4.57±3.41,in patients without anxiety/depression,the serum CRF/CGRP concentration,symptom/HAMA / HAMD scores were all significantly lower after treatment than before treatment(p<0.05).Conclusion 1.The levels of CRF and CGRP in fasting serum of patients with different subgroups of FD were higher than those of healthy people,CRF and CGRP might be involved in the pathogenesis of FD.2.There was no significant difference in the levels of serum CRF and CGRP among PDS group,EPS group and PDS overlapping EPS group.3.The levels of CRF and CGRP in FD patients with anxiety/depression were significantly higher than those in FD patients without anxiety/depression,and CRF and CGRP were positively correlated with HAMA and HAMD scores,suggesting that CRF and CGRP may be associated with anxiety/depression,the levels of CRF and CGRP can affect the severity of anxiety/depression symptoms.4.FD patients have anxiety and depression condition,anxiety symptoms is more obvious in PDS group,postprandial fullness may be an independent factor affecting psychiatric symptoms.5.Deanxit can reduce the serum concentration of CRF and CGRP in patients with FD,improve the symptoms of dyspepsia and anxiety/depression.6.The use of anti-anxiety/depression therapy alone in FD patients with and without anxiety/depression has a good effect. |
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