| Analysis of social demographic characteristics,symptom spectrum,psychological status,life quality in patients with functional dyspepsiaObjective:To investigate the social demographic characteristics,symptom spectrum,psychological status,quality of life in patients with functional dyspepsia.To compare the difference with different subtypes of FD.Methods:Self-Rating Anxiety Scale(SAS), Self-Rating Despression Scale(SDS) and social demographic characteristics,SF-36, symptom questionnaire were recorded in 273 patients with FD.Results:1. All patients were outpatients in China-Japan Friendship Hospital.1. Social demographic characteristics:a total of 273 patients (93 males and 180 females) have completed the valid questionnaires and interview. The average age is 41.3±10.8 years old.The patients of less than 30 years old accounted for 27.5%. The patients of 50-59 years old accounted for 25.3%. In the group of body mass index, the proportion of BMI18.1-23.0kg/m2 can be observed at most (55.3%).The proportion of married patients can be observed at most (76.2%) in the group of marital status.The proportion of patients who had received scholar degree can be observed at most (50.9) in the group of education experience.2.Subtypes:there were 110 patients(40.29%) in the group of PDS,143 patients(52.38%) in the group of PDS+EPS,and 20 patients(7.33%) in the group of EPS.3. Symptoms:postprandial fullness was the most predominant symptom in patients of FD,followed by epigastric distention.4. Psychological status:there was significant difference in SAS between females and males (46.47±10.33 vs 43.43±9.33, P=0.020). The SAS score of 50-59 years old patients was significantly higher than the patients who were<30 years old (48.22±10.57 vs 42.88±11.56, P=0.039). There was significant difference in SDS index in 50-59 years old patients group compared with< 30 years old patients (0.54±0.11 vs 0.46±0.11, P=0.001). There was significant difference in SAS score and SDS index in divorced patients group compared with married patients group (all P=0.001). The SAS score of scholar degree patients were lower than that of junior high school patients (40.40±10.68 vs 48.47±11.20, P=0.001).The SAS score in the group of EPS+PDS was significant higher than the group of PDS(56.88±11.46 vs 41.07±9.95, P=0.001).There was not significant difference in SDS index between EPD+PDS and PDS.5.SF-36:the QOL of females and 50-59 years old was worse than other patients in physical function and psychological function.The QOL of married patients was worse than other patients in physical function and psychological function. The QOL of the PDS+EPS group was worse than the group of PDS in BP,GH and VT.Conclusion:The paper revealed that significant different mental status in patients with functional dyspepsia. There was high score with SAS and SDS in patients of middle-age, women and divorced patients. There was low score with SAS and SDS in patients of highly educated patients.The psychological status and quality of life in the group of EPS+PDS was worse than the group of PDS.The investigation of liquid nutrient load test for evaluating the proximal gastric functionObjective:To analyze the proximal gastric function of functional dyspepsia by liquid nutrient load test (LNLT),then compare the difference of FD and healthy subjects.Methods:A total of 44 patients and 44 healthy subjects from China-Japan Friendship Hospital were recorded that gender, age.Patients were recorded different subtypes. Then all patients received the LNLT and recorded the threshold volume(TV) and maximal volume(MV).Results:A total of 44 patients (22 males and 22 females) and 44 healthy subjects had completed the trial. The patients were divided into 2 subtypes(17 cases in EPS,27 cases in PDS). There were 44 healthy control group,22 females and 22 males.TV of FD were lower than TV of healthy control group (229.66±95.36ml vs 269.77±36.12ml, P=0.012), MV of FD were lower than MV of healthy control group(506.09±220.22ml vs 755.91±79.93ml, P<0.001).TV of males were higher than TV of females (264.77±96.71ml vs 194.55±81.75ml, P=0.013).MV of males were higher than MV of females (584.91±256.37ml vs 427.27±143.40ml, P=0.016). There were 8 malesand 9 femalsin subtype of EPS and 14 malesand 13 femalesin subtype of PDS. There was not significant difference in TV and MV between EPS and PDS.TV of females in PDS were lower than TV of males in PDS (156.15±63.57ml vs 262.50±107.75ml, P=0.005),MV of females in PDS were lower than MV of males in PDS (373.08±117.71ml vs 568.07±222.04ml, P=0.009). Early satiation was significantly related to MV (r=-0.236, P=0.048).Other symptoms were not related to TV and MV.Conclusion:Gastric impaired accommodation appeared in FD patients.The function of gastic sensation was influenced by gender. Early satiation was related to gastric impaired accommodation.Analysis of comparison between empirical treatment andspecific treatment based on the pathological and physiological mechanism in patients with functional dyspepsiaObjective:In this study, patients with FD were randomly divided into the empirical treatment group and the specific treatment group.Two groups were treated with different drugs. To compare the effectiveness of two treatments, the curative effect of gastric function, the situation of mental state and the improvement of life quality.Methods:Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA) and social demographic characteristics,SF-36 quality of life, symptom questionnaire were recorded in 72 patients with FD.All patients examined by 5 hours gastric emptying rate and liquid nutrient load test (LNLT).The patients of empirical treatment group were accepted in famotidine and domperidone.The patients of specific treatment group were accepted in different drugs according to pathophysiological mechanisms. Patients with gastric motility disorders were accepted in Itopride Hydrochloride.The patients with visceral hypersensitivity were accepted in Trimebutine Maleate.The patients with abnormal mental status were accepted in Flupentixol and Melitracen Tablets. The group of patients can be single or multi drug combination.The whole course lasted for 4 weeks. SF-36 quality of life and symptom questionnaire were recorded in all patients after treatment. If the gastric function or psychological were abnormal, they should be reviewed after treatment.Results:1. Baseline characteristics:There were 30 patients in empirical treatment group,including 16 females and 14 males. Mean age was 40.86±11.09 years old. There were 42 patients in specific treatment group,including 15 females and 27 males. Mean age was 40.13±13.82 years old. There were no significant differences in social demographic characteristics, including gender, age, BMI, lifestyle and eating habits.2. Symptom questionnaire of FD:There was no significant difference in the score of the two groups with dyspepsia symptom questionnaire before treatment. There was significant difference between empirical treatment group and specific treatment group after treatment (10.77±6.58vs7.27±6.22, P=0.025). The score of specific treatment group was lower than empirical treatment group.There was significant difference in the number of effective patients between two groups((14vs33, P=0.028). The specific treatment group was more efficient.3.Gastric function:There was no significant difference between two groups in 5 hours gastric emptying rate and LNLT.The 5 hours gastric emptying rate was improved after empirical treatment(7.50(2.00,20.00) vs 30.00(20.00,47.50), P<0.001); TV and MV were improved after empirical treatment. The 5 hours gastric emptying rate was improved after specific treatment(10.00 (0.00,15.00) vs 65.00 (33.75,83.75), P=0.002); TV and MV were improved after specific treatment. The 5 hours gastric emptying rate,TV and MV had reached nomal values.There was significant difference between two groups in gastic function after treatment(P<0.05). 4.Quality of life:The specific treatment group was worse than the expirical treatment group in GH before treatment.There was no significant difference between two groups in 8 dimensions after treatment.There was significant difference in PF,GH,VT,SF,RE after expirical treatment. There was significant difference in PF,RP,GH,VT,SF,MH after specific treatment.5.HAMD/HAMA:There was no significant difference between two groups before treatment.The scores of HAMD/HAMA were less after treatment.Conclusion:The specific treatment was more effective according to the different pathophysiological mechanisms of FD patients. The specific treatment can better improve gastric function... |
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