Research On Influential Factors Of Conventional Treatment Response For Functional Dyspepsia

Objective: The present treatment to FD remains unsatisfactory, andstudies on the influential factors of its treatment response are few. Forimproving symptoms and the quality of life of patients with FD, we aimed toevaluate the influential factors associated with conventional treatmentresponse for FD.Methods: From November 2010 to December 2011, 207 consecutiveoutpatients with FD from our department were enrolled according to theRome III criteria. All recruited cases were subdivided into postprandialdistress syndrome (PDS), epigastric pain syndrome (EPS) and symptomscompatible with both syndromes, and were asked to finish several scalesincluding Nepean dyspepsia index, patient health questionnaire - 15, SASScale, Hamilton depression scale 17 and dyspepsia symptoms severityself-report scale before treatment. The response rates of prokinetic and protonpump inhibitor treatment for PDS and the overlap patients and proton pumpinhibitor treatment for EPS patients were observed after 4 weeks, and aresponder was defined as symptoms relief at least 75%. Chi-square test,Pearson’s or Spearman’s correlation, linear regression and Logistic regressionwere used to analyze the scores of symptoms severity, somatic symptoms,Nepean dyspepsia index, SAS scale, Hamilton depression scale 17 and so on.Results: After treatment, 105 (50.7%) were responders in patients withtotal 207 FD patients, in which 56.3% (27/48) PDS, 39.6% (21/53) EPS and53.8% (57/106) overlap cases were effective. The incidence of depression and anxiety disorder was 55.6% (115/207) and 60.4% (125/207), respectively,both were significantly higher in non-response group than in response group(depression: 65.7% VS 45.7%, respectively; anxiety: 73.5% VS 47.6%,respectively) (both p<0.05). In somatic symptoms, dizziness (OR 0.474,95%CI 0.268 - 0.837; p=0.010), feeling tired (OR 0.293, 95%CI 0.165 - 0.521;p=0.000), dry-mouth (OR 0.425，95%CI 0.243 - 0.744; p=0.003), abdominalpain (OR 0.510，95%CI 0.288 - 0.904; p=0.020) and sore throat (OR 0.271，95%CI 0.085 - 0.862; p=0.019) had significant difference betweennon-response group and response group. Correlation analyses showedcorrelations between depression (r=0.540，p=0.000), anxiety disorder(r=0.356，p=0.000), NDI (r=-0.523，p=0.000) and somatisation. Logisticregression analyses identified NDI (OR 1.091, 95%CI 1.032 - 1.153;p=0.002), somatisation (OR 0.851, 95%CI 0.727 - 0.997; p=0.006), life andeconomy stresses (OR 0.455, 95%CI 0.259 - 0.799; p=0.025) and weight loss(OR 0.359, 95%CI 0.158 - 0.817; p=0.033) were the possible influentialfactors associated with the conventional treatment response for FD.Conclusions: The mainly influential factors of conventional treatmentresponse for FD might be depression, anxiety disorder, NDI, somatisation, lifeand economy stresses and weight loss. Moreover, NDI and somatic symptomsmight be more important.