| Background and purpose:FD is caused by dysfunction of the stomach and duodenum,a set of clinical syndrome with no organic disease,is the most common type of functional gastrointestinal disease.With the progress of the society,the improvement of material life,work and life pressure increases,the incidence of FD is higher than befor,according to the survey data,FD accounted for about 10%of general medical clinic,and about 50%gastroenterology clinic.FD is prone to relapse,the pathogenesis is unknown,and its treatment effect is not as good as we think,leading to repeated medical treatment,wasting medical resources and increasing social economic burden.Most studies have shown that the incidence of FD in developing countries is higher than that in developed countries and may be related to different regional economies and dietary habits.About the pathogenesis of FD,many results showed that related to gastrointestinal disorders,gastrointestinal hormone,visceral sensitivity,psychosocial factors,HP infection,genetic and environmental factors,in recent years,we found that poor living and eating habits are significant factors contributing to FD,classification of concrete mechanism is not yet clear.With the Prokinetics,Digestants and antacids,h.pylori removal,patients symptoms improved,but still easy to be repeated,to a certain extent affect the quality of life,to explore the pathophysiological characteristics and therapeutic effect of FD is particularly important.There is no large sample database to investigate the risk factors,clinical characteristics,therapeutic schedule,treatment effect and its factors of FD,we have established online functional gastrointestinal disease database,than maked case report form according to the epidemiological and clinical characteristics of FD,used the CRF to collect the FD cases,all the information and data will be put into the database,using the database to explore the pathophysiological characteristics and therapeutic effect of FD.Part 1 Using database to explore the pathophysiologicalcharacteristics of functional dyspepsiaMethods:With reference to the Roman ? and Roman ? diagnostic criteria,according to the case report form,we collected 268 patients' clinical data with functional dyspepsia and 128 normal persons' data as the control group from October 2015 to October 2017 in Nanfang Hospital,all the personal information and clinical data will be put into the database,using the database and the statistical software SPSS 20.0 for further analysis the pathophysiological characteristics of functional dyspepsia.Results:I General information and clinical features of FD patientsAmong the 268 FD patients included in the database,132(49.3%)were male and 136(50.7%)were female,age ranged from 14 to 74 years old,average age:41.62±12.15 years old;The patients' occupations consisted of 56 workers(20.9%),47 intellectuals(17.5%),48 businessman(17.9%)and 70 unemployed(26.1%);155 cases from cities(57.8%)and 113 cases from rural areas(42.2%);The main symptoms:194 epigastric bloating(72.4%),119 epigastric pain(44.4%),94 belching(35.1%),43 Poor appetite(16.0%).Mean disease duration:39.32±12.77 month.In the case group,242 patients were tested for HP,144 cases were positive(59,5%),accounting for 53.7%of all cases,the control group of 83 cases detected HP,37 cases were positive(44.6%),accounting for 28.9%of all cases,the difference was statistically significant between the FD group and control group(P<0.05).? Logistic regression analysis of etiology related to FD Pressure(P=0.046,OR=1.657),adverse events in life(P=0.000,OR= 1.196),lack of physical activity(P=0.001,OR=5.076),sitting for a long time(P=0.001,OR=2.762),insufficient sleep(P=0.020,OR=1.822),eating dessert(P=0.040,OR=1.902),drinking too much carbonated beverages(P=0.035,OR=2.351),anxiety-depression(P=0.005,OR=2.527),HP infection(P=0.035,OR=1.988)were all independent risk factors for FD.Conclusion:Both pressure of life,adverse events,anxiety-depression,lack of exercise and insufficient sleep,eating dessert,drinking too much carbonated beverages,HP infection are significant factors contributing to FD,high-risk aged between 20 to 50 years old and associated with the occupation.Part 2 Using database to explore the therapeutic effect and its factorsof functional dyspepsiaMethods:All the therapeutic schedule well be put into the database of the 268 patients,prokinetics+digestant+antacids are the main therapeutic schedule of FD;if the patients with helicobacter pylori infection,basic drug treatment well be after the standard 4 joint sterilization for 2 weeks;with anti-anxiety treatment if the patients have anxiety symptoms.we recorded the different treatment effect after 8 weeks,according to the evaluation criteria of recovery,effectiveness,improvement and invalidity,using the database and the statistical software SPSS 20.0 for further analysis the herapeutic effect and its factors.Results:I Comparison of common medicine with antianxiety drug Ordinary drugs(prokinetics+digestant+antacids)as the main treatment of 198 patients,17 cases were cured(8.6%),105 cases were markedly improved(53.0%),65 cases were better(32.8%),11 cases were not improved(5.6%).Among the 41 patients with antianxiety drugs,3 cases were cured(7.3%),30 cases were markedly improved(73.2%),7 cases were better(17.0%)and 1 case was not improved(2.4%).The overall response rate of general drug was 61.6%,and the overall response rate of anti-anxiety drug was 80.5%,the difference was statistically significant between anti-anxiety medicine group and common medicine group(P<0.05).II Logistic regression analysis of the risk factor of therapeutic effectAnxiety(P=0.005,OR=2.042),insufficient sleep(P=0.040,OR=2.050),drinking too much carbonated beverages(P=0.043,OR=2.661)both were the independent risk factor for poor treatment effect of common medicine.Conclusion:Prokinetics+digestant+antacids are the main therapeutic schedule of FD,with anti-anxiety medicine can improve the symptom of the FD patients,anxiety and lack of sleep and drinking too much carbonated beverages will influence the therapeutic effect. |
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