| Functional dyspepsia(FD) is one of the most common functional gastrointestinal disorders(FGIDs) in recent Rome II diagnostic criteria. The definition includes the following: (l)persistent or recurrent pain or discomfort (fullness, early satiety, bloating, belching, nausea, retching, or vomiting) centered in the upper abdomen more than twelve weeks accumulately within the preceding 12 months; and (2) No evidence that organic diseases is likely to explain the symptoms. In effort to clarify the relationship between FD and chronic gastritis , most researchers focused on helicobacter pylori infection status. But it's still difficult to draw a definite conclusion based on present studies. However, to date, preceding studies seldomly deal with the relationship between FD and nonerosive gastritis with dyspepsia symptoms but no helicobacter pylori infection and specific causes which we named "primary nonerosive gastritis(PNG)" . It's very difficult to differentiate PNG from FD in clinic because of their similar symptoms and endoscopic appearances. Is there difference or correlation in these two diseases in concept? What relationship is there? Our aim was todiscriminate the definition of PNG and FD by the way of treated reaction.5Material and MethodsFrom Jun 2000 to Aug 2001,patients who meet the PNG diagnostic criteria were enrolled.Patients who had H.Pylori infection, presence of peptic ulcer, hepato-biliary diseases, alcohol abuse ,use of aspirin or non-steroidal anti-inflammatory drugs(NSAID) were excluded. Finally 214 patients were enrolled in the study. Patients were randomly assigned to two groups. One group was case control trial group, another was cross-treated self-control group. Ordinary treatment to chronic gastritis(plan A: Ranitidine 150mg po Bid +Selbex 50mg po Tid) and functional dyspepsia plan(plan B: Cisapride lOmg po Tid +Doxepin 25mg po qn +Domeipian 3* poTid)were given. In case control trial, plan A and plan B were given in control group(group A) and case group(group B) for two months. In cross-treated self-control trial, All patients were also assigned to group A and group B. The patients in group A were given plan A for two months at begin. After two months, the symptoms, endoscopic and pathologic changes were recorded. When the symptoms recurred, plan B were given for two months .On the contrary, the patients in group B were given plan B and plan A in turn. After case control trial and cross-treated self-control trial, symptoms, endoscopic and pathologic changes were analyzed and compared. Effectiveness analysis:The effectiveness were analyzed with the change of dyspeptic symptoms, endoscopy and histology of the stomach after treatment."complete remission": symptoms disappearance, endoscopic and6histological findings improving more than II grades;"effectiveness": symptom score(SC) decrement -^50%, endoscopic and histological results decreasing I grade;"no effectiveness" rsymptom score decrement <50%, no change or deterioration in histopathology in comparison with baseline. Statistical analysis:We used the Statistical Package for the Social sciences 10.0(SPSS 10.0 for Windows)for data analysis.All statistics analysis were performed with chi-square test. P values were computered, with statistical significance indicated by a value of p<0.05.ResultsOf 214 patients with primary nonerosive gastritis,88 were in cross-treated self-control trial group and 126 in case control trial group. At baseline, there were no difference among group A and group B in sex, age and grade of symptom and histopathology. In case control group ,the total effective rate of plan A and plan B was 89.19%(66/74) and 88.46%(46/52) respectively. In cross-treated self-control group, the total effective rate of plan A and plan B was 81.82% and 89.77% respectively. There was no significant difference on the effective rate of these two different plans(p>0.05).The result showed that primary nonerosive gastritis and FD are similar disease and maybe work as a same one but named different... |
