| Functional dyspepsia (FD) is a common digestive syndrome.With the developement of society, the pace of life becomes faster and faster, and the psychological stress is growing, and then the incidence rate of FD is increasing. Although the pathogenesis of FD has not yet fully understood, a large number of datas indicate that FD is associated with gastric electrical abnormalities and movement disorders. Now, there are some reports of EGG or gastric motility, a few researches of EGG and gastric motility at the same time, less studies of gastric motility with FD with PDS(postprandial distress syndrome) and EPS(epigastric pain syndrome) group according to RomeⅢ, few reports of effects of prokinetic agents or acid suppression therapy on clinical symptoms and gastric motility of patients with FD and its subtypes.Objective1. To explore the clinical practicality of the detection of gastric motility by bio-impedance method.2. To analyze the characteristics of gastric motility of FD and its subtypes. 3. To explore the clinical significance of the RomeⅢ.4. To certain the effects of domperidone on clinical symptoms, electrical signal and impedance gastric motility of the patients with PDS and EPS.5. To explore the effects of rebeparazole on clinical symptoms, electrical signal and impedance gastric motility of the patients with PDS and EPS.Methods1. Wavelet transform and bio-impedance technique was used to collected electrical signal and impedance gastric motility of healthy group (n=32) and FD (n=162).2. After treatment with domperidone and rebeprazole for 2 and (or) 4 weeks, the symptom scores of FD were used to evaluate the changes of clinical symptom such as postprandial abdominal distention, early satiety, upper abdominal pain and abdominal burning sensation.3. Bio-impedance gastric motility technology was used to explore the effects of domperidone and rebeparazole on electrical signal and impedance gastric motility of the patients with PDS and EPS.Results1. 162 patients with FD were collected. There were 127 females(78.4%) with FD, aged from 18 to 65 years old, and the median age was 46 years old. There were 31 male(88.58%) and 101 female(79.53%) in the 132 patients with abnormal EGG, and 29 male(82.86%) and 105 female(82.68%) in the 134 patients with abnormal gastric impedance, but the difference of the incidence of abnormal EGG and gastric impedance between gender was not significant(P >0.05).2. In FD group, the percentages of the power of the dominant frequency of EGG and impedance gastrogram were (53.18±6.79)% and (52.14±6.36)%, and which were significantly lower than those of the healthy group[(60.5±3.99)%,(58.96±3.88)%](P<0.05),respectively.The percentages of the power of the abnormal frequency of EGG[low-frequency (26.54±6.26)%,high-frequency(20.2±5.04)%] and impedance gastrogram [low-frequency(29.6±8.22)%,high-frequency(18.04±6.18)%] were much higher than those of the healthy group(P<0.05).3. In FD group, according to the reference values with 95%CI of the healthy group, there were 30(18.52%) patients with the normal percentages of the power of the dominant frequency of EGG, 132(81.48%) patients in the abnormal range, 88(54.32%) patients with both abnormal of low and high frequency of EGG, 40(24.69%) patients with only abnormal of low frequency of EGG, 4(2.47%) patients with only abnormal of high frequency of EGG. According to the reference values with 95%CI of the healthy group,there were 28(17.28%) patients with the normal percentages of the power of the dominant frequency of impedance gastrogram, 134(82.72%) patients in the abnormal range, 73(45.06%) patients with both abnormal of low and high frequency of impedance gastrogram, 1(0.62%) patients with both normal of low and high frequency of impedance gastrogram, 54(33.33%) patients with only abnormal of low frequency of impedance gastrogram, 6(3.7%) patients with only abnormal of high frequency of impedance gastrogram.4. In FD group, there were 7(4.32%) patients with both normal EGG and gastric impedance, 111(68.52%) patients with both abnormal EGG and gastric impedance, 21(12.93%) patients with only abnormal EGG, and 23(14.2%) patients with only abnormal gastric impedance.5. There were significant differences in the percentages of the power of the low frequency of EGG between PDS group [(28.88±6.38)%] and EPS group [(22.87±3.87)%], and the same as the dominant frequency of that between PDS group[(52.89±6.02)%] and EPS group[(53.64±7.87)%] (P<0.05). In PDS group, according to the reference values with 95%CI of the healthy group, there were 15(11.81%) patients with the normal percentages of the power of the dominant frequency of EGG, 84(84.85%) patients in the abnormal range, 42(42.42%) patients with both abnormal of low and high frequency of EGG, 40(40.4%) patients with only abnormal of low frequency of EGG, 2(2.02%) patients with only abnormal of high frequency of EGG. In EPS group, according to the reference values with 95%CI of the healthy group, there were 15(23.81%) patients with the normal percentages of the power of the dominant frequency of EGG, 48(76.19%) patients in the abnormal range, 46(73.02%) patients with both abnormal of low and high frequency of EGG, 2(3.17%) patients with only abnormal of high frequency of EGG.6. There were significant differences in the percentages of the power of the low, dominant frequency of impedance gastrogram of PDS group[(34.16±6.64)%, (50.88±5.2)%] and EPS group[(22.45±4.53)%, (54.13±7.48)%] (P<0.05). In PDS group, according to the reference values with 95%CI of the healthy group, there were 11(11.11%) patients with the normal percentages of the power of the dominant frequency of impedance gastrogram, 88(88.89%) patients in the abnormal range, 33(33.33%) patients with both abnormal of low and high frequency of impedance gastrogram, 1(1.01%) patients with both normal of low and high frequency of impedance gastrogram, 54(54.54%) patients with only abnormal of low frequency of impedance gastrogram. In EPS group, according to the reference values with 95%CI of the healthy group, there were 17(26.98%) patients with the normal percentages of the power of the dominant frequency of impedance gastrogram, 46(73.02%) patients in the abnormal range, 40(63.49%) patients with both abnormal of low and high frequency of impedance gastrogram, 6(9.52%) patients with only abnormal of high frequency of impedance gastrogram.7. Domperidone(10mg,tid) can significantly improve symptoms of postprandial abdominal distention, early satiety, upper abdominal pain and abdominal burning sensation of PDS and EPS group after treatment for 2 weeks(P<0.05), but not of abdominal burning sensation of PDS group and early satiety and upper abdominal pain of EPS group for 4 weeks(P>0.05).8. There was a significant increase in the percentages of the power of the dominant frequency of EGG of PDS group [(52.27±5.38)%, (55.62±5.25)%, (59.13±6.46)%] and EPS group [(47.64±5.97)%, (53.54±4.92)%, (58.29±4.3)%] before and after treatment with domperidone(10mg,tid) for 2 and 4 weeks(P<0.05).9. The percentages of the power of the dominant frequency of impedance gastrogram in PDS group raised to (48.51±3.61)% after treatment with domperidone(10mg,tid) for 2 weeks, and furtherly raised to (52.56±5.17)% for 4 weeks(P<0.05), but that in EPS group raised significantly to(49.42±3.55)% after treatment with domperidone(10mg,tid) for 4 weeks(P<0.05).10. After 2 weeks treatment, rabeprazole(10mg,qd) can significantly improve symptoms of postprandial abdominal distention, upper abdominal pain and abdominal burning sensation in PDS group, and upper abdominal pain and abdominal burning sensation in EPS group(P<0.05).11. After 2 weeks of rabeprazole(10mg,qd) for treatment, the percentages of the power of the dominant frequency of EGG and impedance gastrogram in PDS and EPS group raised from[(53.74±7.41)%, (51.03±6.13)%] to [(56.62±6.24)%, (55.85±4.66)%], and the high-frequency of that lower from[(23.31±3.72)%, (23.87±4.00)%]to [(20.88±4.26)%, (20.97±3.49)%] (P<0.05).12. There was no significant difference in the percentages of the power of the low, dominant, high frequency of impedance gastrogram of PDS and EPS group after treatment with rabeprazole(10mg,qd) for 2 weeks(P>0.05).Conclusion1. FD is usually occured in middle-agged women. There is no significant correlation between the incidence of abnormal gastric motility and gender.2. Wavelet transform and bio-impedance technique can be used to evaluate gastric motility corresponding gastrointestinal physiology and pathology conditions.3. Gastric motility disorder is one of the pathogenesis of FD. There are mainly bradygastria in PDS. It is more common of patients with normal EGG and gastric motility of EPS than those of PDS.4. The classification of RomeⅢmay be benefit to treatment of FD.5. Domperidone(10mg,tid) can relieve clinical symptoms, improve electrical signal and impedance gastric motility of PDS and EPS group. Comparing with EPS group, the effect of domperidone in PDS group is more obvious, especially after treatment for 4 weeks.6. Our primary results indicate that rabeprazole(10mg,qd) can relieve clinical symptoms and improve electrical signal, but not impedance gastric motility of PDS and EPS group. |
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